Ottis Elwood Toole was an American who was convicted of six counts of murder and at one time admitted to four more murder charges. However, he recanted and restated a number of confessions during his time in prison. Police believe he was responsible for the murder of Adam Walsh in 1981. Toole received two death sentences but on appeal they were commuted to life in prison. He died in his cell from liver disease.

Index card signed in full with HAND OF DEATH on the front and drawing of the infamous hand on the back.