| Date of birth: | Jun 14, 1947 |
| Ethnicity: | White |
| Hair: | Brown |
| Eyes: | Hazel |
| Sbi number: | 880394 |
| Admission date: | Oct 1, 2004 |
| Booking location: | Atlantic County, NJ |
| Discharge date: | Oct 1, 2004 |
| Offense date: | Sep 9, 2003 |
| Offense: | 1 count of : 2C:7-2*4 Registration/Sex Offender-Failr to Reg/4 |
| Maximum term: | 365 Days |
| County of commitment: | Atlantic |
| Commitment order: | ATL031202341I |