| Date of birth: | 1937 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 128892 |
| SO#: | 68868 |
| Booked at: | SALT LAKE |
| Cob: | Kansas |
| Booking number: | 9716437 |
| Booking date: | Jul 21, 1997 |
| Release date: | Jul 21, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $900 |