| Date of birth: | 1921 |
| Cell block: | Booking - Pit |
| Arrest date: | Sep 28, 2016 |
| Booking location: | Douglas County, GA |
| Description: | Charge: 16-10-25 - Giving False Name, Address/DOB to Officers (Pending); Arrest Date 09/28/2016; Bond - Bonding Company, $2000.00; Set By Preset; |