| Date of birth: | 1948 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 140973 |
| SO#: | 77273 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0416636 |
| Booking date: | Jul 11, 2004 |
| Release date: | Jul 12, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 961000238 |
| Amount: | $570 |
| Number: | C02-06528 |
| Amount: | $2,500 |
