| Date of birth: | Jul 13, 1936 |
| Hair: | Salt/pepper |
| Eyes: | Brown |
| Inmate number: | 00017068 |
| Booking number: | 2003006190 |
| Booking date: | Oct 4, 2003 |
| Release date: | Oct 5, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 320.261 - ATTACHING TAG NOT ASSIGNED |
| Offense date: | Oct 4, 2003 |
| Bond amount: | $500 |
| Statute: | 320.061 - VALIDATION STICKER |
| Offense date: | Oct 4, 2003 |
| Bond amount: | $500 |
