| Date of birth: | 1964 |
| Hair: | Black |
| Eyes: | Brown |
| SO#: | 281425 |
| Booked at: | SALT LAKE |
| Cob: | Wyoming |
| Citizen: | UNITED STATES |
| Booking number: | 0415133 |
| Booking date: | Jun 23, 2004 |
| Release date: | Jun 28, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $5,000 |
| Number: | 03CR09345 |
| Amount: | $1,500 |