| Date of birth: | 1955 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 354325 |
| SO#: | 218675 |
| Booked at: | SALT LAKE |
| Citizen: | UNITED STATES |
| Booking number: | 0416762 |
| Booking date: | Jul 13, 2004 |
| Release date: | Sep 1, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 021907810 |
| Amount: | $20,000 |