| Date of birth: | Mar 30, 1954 |
| Hair: | Black |
| Eyes: | Brown |
| SO#: | 71998 |
| Arresting agency: | Department of Public Safety |
| Booking number: | 74814 |
| Booking date: | Dec 7, 2004 |
| Release date: | Dec 7, 2004 |
| Booking location: | Brazoria County, TX |
| Warrant: | D041474 |
| Offense date: | Nov 27, 2004 |
| Issuing authority: | 2-2 |
| Charge: | FICTITIOUS COUNTERFEIT INSP/INS DOC FOR DISPLAY |