| Date of birth: | 1944 |
| Hair: | Gray |
| Eyes: | Blue |
| Registration: | 59979 |
| Level: | Offender |
| Classification: | Offender |
| Arresting agency: | Polk County Sheriff's Office |
| Booking location: | Florida |
| Booking number: | 59979 |
| Jail name: | Indiana Sheriffs Association |
| Location: | 147 Maryland St, Indianapolis, IN 46204 |
| Details: | 99.99-Crimes from Other States / Federal |
| Details: | 99.99-Crimes from Other States / Federal |
| Description: | 9999 - OTHER CRIME |
| Charges: | N/A |