| Date of birth: | 1944 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 276010 |
| SO#: | 150255 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Citizen: | UNITED STATES |
| Booking number: | 0427521 |
| Booking date: | Nov 21, 2004 |
| Release date: | Nov 23, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $52,089 |