| Date of birth: | Mar 5, 1958 |
| Hair: | Gray |
| Eyes: | Hazel |
| Inmate number: | 00017057 |
| Booking number: | 2003006162 |
| Booking date: | Oct 3, 2003 |
| Release date: | Oct 3, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/PLEA DAY W/C |
| Offense date: | Oct 3, 2003 |
| Case number: | 2003MM006532C |
| Bond amount: | $250 |