| Date of birth: | 1952 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 168248 |
| SO#: | 98838 |
| Booked at: | SALT LAKE |
| Cob: | District of Columbia |
| Citizen: | UNITED STATES |
| Booking number: | 0402567 |
| Booking date: | Jan 31, 2004 |
| Release date: | Feb 5, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 168248 |