| Date of birth: | 1918 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 087966 |
| SO#: | 40683 |
| Booked at: | SALT LAKE |
| Cob: | Minnesota |
| Booking number: | 9417794 |
| Booking date: | Sep 21, 1994 |
| Release date: | Sep 30, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,060 |
| Number: | 940045424MC |
| Amount: | $800 |
