| Date of birth: | 1973 |
| Hair: | Bald |
| Eyes: | Hazel |
| State id: | 1046932 |
| SO#: | 278074 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0403609 |
| Booking date: | Feb 12, 2004 |
| Release date: | Feb 16, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 03CR15302 |
| Amount: | $5,005 |