| Date of birth: | 1942 |
| Hair: | Gray or partially gray |
| Eyes: | Green |
| State id: | 130597 |
| SO#: | 70199 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0325987 |
| Booking date: | Oct 15, 2003 |
| Release date: | Nov 12, 2003 |
| Booking location: | Salt Lake County, UT |