| Date of birth: | 1951 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 1022729 |
| SO#: | 270606 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0402511 |
| Booking date: | Jan 30, 2004 |
| Release date: | Feb 4, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 031901969 |