| Date of birth: | 1957 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 219012 |
| SO#: | 129774 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 0430154 |
| Booking date: | Dec 23, 2004 |
| Release date: | Dec 23, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 041102758 |
| Amount: | $10,000 |