| Date of birth: | Apr 9, 1950 |
| Hair: | Brown |
| Eyes: | Blue |
| SO#: | 120159 |
| Arresting agency: | Department of Public Safety |
| Booking number: | 75572 |
| Booking date: | Dec 30, 2004 |
| Release date: | Dec 30, 2004 |
| Booking location: | Brazoria County, TX |
| Warrant: | DJ006377 |
| Offense date: | Dec 30, 2004 |
| Issuing authority: | 2-2 |
| Charge: | FICTITIOUS COUNTERFEIT INSP/INS DOC FOR DISPLAY |