| Date of birth: | 1937 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 241385 |
| SO#: | 137035 |
| Booked at: | SALT LAKE |
| Cob: | Oregon |
| Booking number: | 9611745 |
| Booking date: | Jun 27, 1996 |
| Release date: | Jun 28, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 951024800FS |
| Amount: | $25,000 |
