| Date of birth: | Nov 16, 1943 |
| Hair: | White |
| Eyes: | Green |
| Photo date: | Oct 9, 2004 |
| Id number: | 205462 |
| Arrest date: | Oct 9, 2004 |
| Booking number: | 358425 |
| Release date: | Oct 21, 2004 |
| Booking location: | Lee County, FL |
| Type: | Felony |
| Description: | OUT OF COUNTY "HIT" DADE CO |
| Court: | County Court |
| Case number: | F812458 |
| Agency: | LCSO |