| Date of birth: | 1939 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 578662 |
| SO#: | 239638 |
| Booked at: | SALT LAKE |
| Cob: | Maryland |
| Booking number: | 9922302 |
| Booking date: | Sep 9, 1999 |
| Release date: | Sep 21, 1999 |
| Booking location: | Salt Lake County, UT |
| Amount: | $5,000 |
| Number: | 991918350FS |