| Date of birth: | Dec 28, 1950 |
| Hair: | Brown |
| Eyes: | Hazel |
| Inmate number: | 00013669 |
| Booking number: | 2002006265 |
| Booking date: | Oct 10, 2002 |
| Release date: | Oct 15, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/VOP |
| Offense date: | Oct 10, 2002 |
| Bond amount: | $2,500 |