| Date of birth: | 1935 |
| Hair: | Gray |
| Eyes: | Brown |
| Registration: | 105100 |
| Comments: | PER FDLE SUB CURRENT PERM ADDRESS IS 35 ARTHUR LN WINTER HAVEN, FL 33880/PENDING RTR |
| Description: | Scar on L_leg (NAVY INJURY) |
| Description: | Scar on Chest (HEART SURGERY) |
| Booking location: | Florida |