| Date of birth: | 1913 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| SO#: | 134560 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Booking number: | 9402388 |
| Booking date: | Feb 6, 1994 |
| Release date: | Feb 6, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 931000725 |
| Amount: | $1,570 |