| Date of birth: | 1941 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| SO#: | 207463 |
| Booked at: | SALT LAKE |
| Cob: | Mississippi |
| Booking number: | 9523459 |
| Booking date: | Nov 5, 1995 |
| Release date: | Nov 5, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,250 |
| Number: | DH1354A |
| Amount: | $100 |