| Date of birth: | 1945 |
| Hair: | Gray or partially gray |
| Eyes: | Hazel |
| State id: | 140007 |
| SO#: | 76586 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Citizen: | UNITED STATES |
| Booking number: | 0900576 |
| Booking date: | Jan 7, 2009 |
| Release date: | Jan 9, 2009 |
| Booking location: | Salt Lake County, UT |
| Number: | 041501686 |
| Amount: | $2,005 |