| Date of birth: | Apr 1, 1955 |
| Hair: | Black |
| Eyes: | Brown |
| Inmate number: | 00019246 |
| Booking number: | 2004003353 |
| Booking date: | May 12, 2004 |
| Release date: | Jun 30, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 831.02 - UFI 3CTS; GT |
| Offense date: | May 12, 2004 |
| Case number: | 04CF1041 |
| Bond amount: | $2,500 |