| Date of birth: | 1935 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 602099 |
| SO#: | 239172 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9931436 |
| Booking date: | Dec 23, 1999 |
| Release date: | Dec 23, 1999 |
| Booking location: | Salt Lake County, UT |
| Amount: | $925 |