| Date of birth: | 1944 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 413035 |
| SO#: | 180709 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Booking number: | 9613630 |
| Booking date: | Jul 26, 1996 |
| Release date: | Aug 1, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 941000154 |
| Number: | NA |
| Amount: | $150 |
