| Date of birth: | Mar 2, 1949 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00019451 |
| Booking number: | 2004003848 |
| Booking date: | May 30, 2004 |
| Release date: | May 31, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY (DOMV) |
| Offense date: | May 30, 2004 |
