| Date of birth: | 1944 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 334212 |
| SO#: | 168642 |
| Booked at: | SALT LAKE |
| Cob: | New York |
| Booking number: | 9619265 |
| Booking date: | Oct 3, 1996 |
| Release date: | Oct 17, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $10,000 |
| Number: | 961021322FS |
| Amount: | $5,000 |
