| Date of birth: | 1940 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 507665 |
| SO#: | 228581 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Citizen: | UNITED STATES |
| Booking number: | 0303092 |
| Booking date: | Feb 1, 2003 |
| Release date: | Feb 2, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |