| Date of birth: | 1941 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 141843 |
| SO#: | 212824 |
| Booked at: | SALT LAKE |
| Cob: | Oregon |
| Booking number: | 9823647 |
| Booking date: | Oct 11, 1998 |
| Release date: | Oct 11, 1998 |
| Booking location: | Salt Lake County, UT |
| Number: | 96402109 |
| Amount: | $750 |