| Date of birth: | 1942 |
| Hair: | Black |
| Eyes: | Brown |
| SO#: | 192699 |
| Booked at: | SALT LAKE |
| Cob: | Nebraska |
| Booking number: | 9321675 |
| Booking date: | Dec 11, 1993 |
| Release date: | Dec 23, 1993 |
| Booking location: | Salt Lake County, UT |
| Number: | 931014973 |
| Amount: | $250 |
| Number: | NA |
| Amount: | $50 |
