| Date of birth: | 1930 |
| Hair: | Brown |
| Eyes: | Hazel |
| SO#: | 215119 |
| Booked at: | SALT LAKE |
| Cob: | Oregon |
| Booking number: | 9621101 |
| Booking date: | Oct 26, 1996 |
| Release date: | Dec 16, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $3,000 |
| Number: | 961022875FS |
| Amount: | $10,000 |
