| Date of birth: | 1944 |
| Hair: | Sandy |
| Eyes: | Blue |
| State id: | 206062 |
| SO#: | 101792 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9722444 |
| Booking date: | Oct 3, 1997 |
| Release date: | Oct 3, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $500 |
| Number: | 5-965000915 |