| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 232178 |
| SO#: | 130585 |
| Booked at: | SALT LAKE |
| Cob: | Texas |
| Booking number: | 9417528 |
| Booking date: | Sep 18, 1994 |
| Release date: | Sep 28, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 941000698 |
| Amount: | $170 |
| Number: | 941007082 |
| Amount: | $1,000 |
