| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 140636 |
| SO#: | 56244 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9400750 |
| Booking date: | Jan 12, 1994 |
| Release date: | Jan 13, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $5,000 |
| Number: | 921002826 |
| Amount: | $170 |