| Date of birth: | Nov 29, 1947 |
| Hair: | Black |
| Eyes: | Brown |
| Inmate number: | 00001460 |
| Booking number: | 2003007602 |
| Booking date: | Dec 4, 2003 |
| Release date: | Dec 7, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - CIVIL COMMIT CHILD SUPPORT |
| Offense date: | Dec 4, 2003 |
| Case number: | 76-1859-FD-B |
| Bond amount: | $300 |