| Date of birth: | 1935 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 210802 |
| SO#: | 120894 |
| Booked at: | SALT LAKE |
| Cob: | Oregon |
| Booking number: | 9424672 |
| Booking date: | Dec 30, 1994 |
| Release date: | Jan 2, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 931001719 |
| Amount: | $2,500 |