| Date of birth: | 1971 |
| Hair: | Black |
| Eyes: | Hazel |
| State id: | 1044220 |
| SO#: | 277522 |
| Booked at: | SALT LAKE |
| Cob: | Washington |
| Citizen: | UNITED STATES |
| Booking number: | 0400143 |
| Booking date: | Jan 3, 2004 |
| Release date: | Jan 3, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,847 |