| Date of birth: | May 12, 1954 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00005399 |
| Booking date: | Sep 7, 2000 |
| Release date: | Oct 2, 2000 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/UTTERING FORGED INSTRUMENT |
| Offense date: | Sep 7, 2000 |
| Case number: | 97-1063CFA |