| Date of birth: | 1919 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 648699 |
| SO#: | 102240 |
| Booked at: | SALT LAKE |
| Citizen: | UNITED STATES |
| Booking number: | 0304768 |
| Booking date: | Feb 20, 2003 |
| Release date: | Feb 26, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $480 |
| Number: | 03CR02772 |
| Amount: | $540 |