| Date of birth: | 1959 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 277463 |
| SO#: | 284350 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0426282 |
| Booking date: | Nov 5, 2004 |
| Release date: | Nov 5, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 041101604 |
| Amount: | $5,000 |