| Date of birth: | 1930 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 510066 |
| SO#: | 231283 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9821180 |
| Booking date: | Sep 11, 1998 |
| Release date: | Sep 11, 1998 |
| Booking location: | Salt Lake County, UT |
| Number: | 981917304 |
| Amount: | $1,000 |