| Date of birth: | 1939 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 176930 |
| SO#: | 200091 |
| Booked at: | SALT LAKE |
| Cob: | Texas |
| Booking number: | 9423440 |
| Booking date: | Dec 12, 1994 |
| Release date: | Dec 15, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |
| Number: | 941900464 |