| Date of birth: | Oct 21, 1938 |
| Hair: | Salt/pepper |
| Eyes: | Hazel |
| Inmate number: | 00017576 |
| Booking number: | 2003007397 |
| Booking date: | Nov 24, 2003 |
| Release date: | Mar 22, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - GRAND THEFT |
| Offense date: | Nov 24, 2003 |
| Case number: | 03CF2400 |