| Date of birth: | 1933 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 117244 |
| SO#: | 59618 |
| Booked at: | SALT LAKE |
| Cob: | Washington |
| Booking number: | 9502251 |
| Booking date: | Jan 30, 1995 |
| Release date: | Oct 2, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $150,000 |
| Number: | 951001964FS |