| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 292784 |
| SO#: | 161181 |
| Booked at: | SALT LAKE |
| Cob: | INDONESIA |
| Booking number: | 9410918 |
| Booking date: | Jun 16, 1994 |
| Release date: | Jun 30, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $5,000 |
| Number: | 941009329FS |
| Amount: | $2,500 |
