| Date of birth: | Jul 22, 1940 |
| Hair: | Gray |
| Eyes: | Blue |
| Inmate number: | 00032547 |
| Booking number: | 2007004899 |
| Booking date: | Jun 20, 2007 |
| Release date: | Jun 20, 2007 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - LIABILITY OF COMPENSATION |
| Offense date: | Jun 20, 2007 |
| Statute: | DEL.9999.999 - INSURANCE FRAUD(WORKERS COMP) |
| Offense date: | Jun 20, 2007 |