| Date of birth: | 1937 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 139881 |
| SO#: | 76515 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Booking number: | 9503057 |
| Booking date: | Feb 9, 1995 |
| Release date: | Feb 9, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 203943004539 |
| Amount: | $430 |