| Date of birth: | 1958 |
| Hair: | Blonde |
| Eyes: | Blue |
| SO#: | 275635 |
| Booked at: | SALT LAKE |
| Cob: | West Virginia |
| Citizen: | UNITED STATES |
| Booking number: | 0325533 |
| Booking date: | Oct 9, 2003 |
| Release date: | Oct 9, 2003 |
| Booking location: | Salt Lake County, UT |
| Number: | 005914683 |
| Amount: | $1,500 |