| Date of birth: | 1944 |
| Hair: | Blonde |
| Eyes: | Green |
| State id: | 407987 |
| SO#: | 215461 |
| Booked at: | SALT LAKE |
| Cob: | Ohio |
| Booking number: | 9622230 |
| Booking date: | Nov 9, 1996 |
| Release date: | Nov 13, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $300 |
| Number: | 961001952 |