| Date of birth: | Sep 6, 1953 |
| Hair: | Gray |
| Eyes: | Brown |
| Number: | 00014107 |
| Booking date: | Dec 1, 2002 |
| Release date: | Dec 2, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/(VOP/GT),(VOP/POCS),(VOP/FORGERY),(VOP/UFI),(VOP/EXPLOTATION OF DISABLED OR AGED PERSON) |
| Offense date: | Dec 1, 2002 |
| Bond amount: | $5,000 |