| Date of birth: | 1933 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 85878 |
| SO#: | 44491 |
| Booked at: | SALT LAKE |
| Cob: | Indiana |
| Booking number: | 9921410 |
| Booking date: | Aug 30, 1999 |
| Release date: | Aug 31, 1999 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,567 |