| Date of birth: | Dec 30, 1952 |
| Hair: | Brown |
| Eyes: | Brown |
| Residency: | Resident |
| Marital status: | Single |
| Juvenile: | No |
| Citizen: | Y |
| Birth place: | NH |
| Booking location: | Charlotte County, FL |
| Statute description: | CRIMINAL REGISTRANT |
| Statute: | 9040 |
| Offense date: | Jul 13, 2004 |
| Obts number: | 0801016094 |
| Level: | N |
| Charge: | L |
