| Date of birth: | 1949 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | OR13199074 |
| SO#: | 266024 |
| Booked at: | SALT LAKE |
| Cob: | Delaware |
| Citizen: | UNITED STATES |
| Booking number: | 0221155 |
| Booking date: | Sep 18, 2002 |
| Release date: | Sep 26, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $615 |
| Number: | Y0017958 |
| Amount: | $250 |