| Date of birth: | 1954 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 207331 |
| SO#: | 119556 |
| Booked at: | SALT LAKE |
| Cob: | Maryland |
| Citizen: | UNITED STATES |
| Booking number: | 0429758 |
| Booking date: | Dec 18, 2004 |
| Release date: | Jan 5, 2005 |
| Booking location: | Salt Lake County, UT |
| Amount: | $2,405 |
| Number: | 97-01416 |
| Amount: | $620 |