| Date of birth: | 1942 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 362081 |
| SO#: | 179576 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Booking number: | 9619423 |
| Booking date: | Oct 5, 1996 |
| Release date: | Oct 5, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 951024822 |
| Amount: | $570 |
| Number: | 955002414 |
| Amount: | $210 |