| Date of birth: | 1934 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 44789 |
| SO#: | 270064 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0305123 |
| Booking date: | Feb 23, 2003 |
| Release date: | Feb 23, 2003 |
| Booking location: | Salt Lake County, UT |
| Number: | 015200013 |
| Amount: | $5,000 |