| Date of birth: | 1960 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 342225 |
| SO#: | 279942 |
| Booked at: | SALT LAKE |
| Cob: | Nevada |
| Citizen: | UNITED STATES |
| Booking number: | 0409472 |
| Booking date: | Apr 15, 2004 |
| Release date: | Apr 23, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $25,000 |
| Number: | 041601036 |
| Amount: | $1,000 |
