| Date of birth: | 1955 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 193217 |
| SO#: | 113018 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0411115 |
| Booking date: | May 4, 2004 |
| Release date: | May 13, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 015013383 |
| Amount: | $2,505 |
| Number: | 015016981 |
| Amount: | $200 |
| Number: | 025607233 |
| Amount: | $200 |
