| Date of birth: | 1952 |
| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 285248 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Citizen: | UNITED STATES |
| Booking number: | 0429732 |
| Booking date: | Dec 18, 2004 |
| Release date: | Dec 18, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $2,964 |
| Number: | 015004969 |
| Amount: | $250 |
| Number: | T03-09771 |
| Amount: | $190 |
