| Date of birth: | 1951 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 327869 |
| SO#: | 179239 |
| Booked at: | SALT LAKE |
| Cob: | Florida |
| Booking number: | 9401234 |
| Booking date: | Jan 19, 1994 |
| Release date: | Feb 8, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 912011101TC |
| Amount: | $600 |