| Date of birth: | May 19, 1928 |
| Hair: | Gry/blk |
| Eyes: | Xxx |
| Inmate number: | 1801043829 |
| Incarcerated: | True |
| City of birth: | PALATKA |
| Arresting agency: | Flagler County Sheriff's Office |
| Booking number: | 2015-00001086 |
| Booking date: | May 20, 2015 |
| Booking location: | Flagler County, FL |
| Statute: | 784.021DV |
| Description: | Agg Assault/Domestic Violence |