| Date of birth: | May 8, 1934 |
| Hair: | Gray |
| Eyes: | Brown |
| Number: | 00001265 |
| Inmate number: | 00001265 |
| Booking number: | 2003005836 |
| Booking date: | Sep 18, 2003 |
| Release date: | Sep 18, 2003 |
| Booking location: | Okaloosa County, FL |
| Booking date: | Jan 1, 2000 |
| Release date: | Jan 1, 2000 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/FORGERY OF PRESCRIPTION 4 CTS/ WASHINGTON CO. |
| Offense date: | Sep 18, 2003 |
| Case number: | 00-60 |
| Statute: | 893.13 - POSSESSION OF PARAPHENALIA |
| Offense date: | Jan 1, 2000 |
| Bond amount: | $1,500 |
