| Date of birth: | 1938 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 350268 |
| SO#: | 102369 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9906360 |
| Booking date: | Mar 11, 1999 |
| Release date: | Mar 12, 1999 |
| Booking location: | Salt Lake County, UT |
| Amount: | $100 |
| Number: | 94203555 |
| Amount: | $310 |