| Date of birth: | 1923 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| SO#: | 210458 |
| Booked at: | SALT LAKE |
| Cob: | North Carolina |
| Booking number: | 9606097 |
| Booking date: | Mar 18, 1996 |
| Release date: | Apr 4, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 951016159FS |
| Amount: | $5,000 |