| Date of birth: | 1930 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 86262 |
| SO#: | 40072 |
| Booked at: | SALT LAKE |
| Cob: | Washington |
| Booking number: | 9715678 |
| Booking date: | Jul 12, 1997 |
| Release date: | Jul 14, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $647 |
| Number: | 975000926 |
| Amount: | $2,500 |
