| Date of birth: | 1934 |
| Hair: | Grey |
| Eyes: | Brown |
| Sbi number: | 03710525 |
| Marital status: | Single |
| Juvenile: | No |
| Jurisdiction: | FL0080000 |
| Jca number: | 75694 |
| Employment: | UNKNOWN OR NOT STATED |
| Citizen: | Y |
| Birth place: | NORTH CAROLINA |
| Booking officer: | HENSHAW, BRITTANY |
| Booking location: | Charlotte County, FL |