| Date of birth: | 1952 |
| Hair: | Gray or partially gray |
| Eyes: | Hazel |
| SO#: | 279872 |
| Booked at: | SALT LAKE |
| Cob: | Oregon |
| Citizen: | UNITED STATES |
| Booking number: | 0409207 |
| Booking date: | Apr 13, 2004 |
| Release date: | Apr 13, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,650 |