| Date of birth: | 1936 |
| Hair: | Brown |
| Eyes: | Green |
| State id: | 274832 |
| SO#: | 109495 |
| Booked at: | SALT LAKE |
| Cob: | Colorado |
| Citizen: | UNITED STATES |
| Booking number: | 0319326 |
| Booking date: | Jul 31, 2003 |
| Release date: | Oct 15, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |
| Number: | 021908613 |
| Amount: | $15,000 |
| Number: | 03CR11935 |
| Amount: | $270 |
