| Date of birth: | 1940 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 376505 |
| SO#: | 192313 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Booking number: | 9320346 |
| Booking date: | Nov 18, 1993 |
| Release date: | Nov 22, 1993 |
| Booking location: | Salt Lake County, UT |
| Number: | 925002375 |
| Number: | 935001580 |
| Amount: | $150 |