| Date of birth: | 1939 |
| Hair: | Blonde |
| Eyes: | Hazel |
| State id: | 405367 |
| SO#: | 195631 |
| Booked at: | SALT LAKE |
| Cob: | Kansas |
| Booking number: | 9823155 |
| Booking date: | Oct 5, 1998 |
| Release date: | Oct 6, 1998 |
| Booking location: | Salt Lake County, UT |
| Number: | 941001363 |
| Amount: | $600 |