| Date of birth: | 1924 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 501916 |
| SO#: | 108240 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Booking number: | 9719270 |
| Booking date: | Aug 23, 1997 |
| Release date: | Aug 24, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $500 |