| Date of birth: | Jan 17, 1941 |
| Hair: | Gray |
| Eyes: | Brown |
| Docket no: | 1394295 |
| Complexion: | MED |
| Birth place: | VA |
| Arrest date: | Feb 26, 2010 |
| Arresting agency: | CLEARWATER POLICE |
| Booking type: | MISDEMEANOR |
| Statute: | 562.11(1)/M |
| Offense description: | SELL/GIVE/SERVE ALCOHOL TO PERSON 21 |
| Obts: | 5206066658 |
| Court case: | CTC1004803MMANO |
| Charge number: | 1 |
| Agency report number: | CW10021292 |