| Date of birth: | 1939 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 361479 |
| SO#: | 179337 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Booking number: | 9321688 |
| Booking date: | Dec 11, 1993 |
| Release date: | Dec 13, 1993 |
| Booking location: | Salt Lake County, UT |
| Number: | 925002138 |
| Amount: | $1,500 |