| Date of birth: | Aug 7, 1937 |
| Hair: | Gray |
| Eyes: | Brown |
| Inmate number: | 00017218 |
| Booking number: | 2003006551 |
| Booking date: | Oct 18, 2003 |
| Release date: | Oct 19, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY/DOMV |
| Offense date: | Oct 18, 2003 |