| Date of birth: | 1949 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 343314 |
| SO#: | 180149 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Booking number: | 9502216 |
| Booking date: | Jan 29, 1995 |
| Release date: | Jan 29, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 911014685 |
| Amount: | $1,000 |