| Date of birth: | 1941 |
| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 000027402 |
| Releasing officer: | 097038 |
| Duration of custody: | 8 |
| Comments: | A/CLARK W-G/ ELONG OTN/127424393 |
| Birth place: | GA |
| Booking date: | Jan 25, 2006 |
| Arrest number: | 493320 |
| Arrest location: | 6444 JANE DR |
| Arrest date: | Jan 25, 2006 |
| Arresting agency: | GA0330000 |
| Booking location: | Cobb County, GA |
| Type: | OT |
| Side: | R |
| Description: | HEART |
| Body part: | A |
| Arresting agency: | GA0330000 |
| Arrest number: | 000493320 |
| Arrest date: | Jan 25, 2006 |
| Arrest location: | 6444 JANE DR |
| Booking date: | Jan 25, 2006 |
| Booking location: | Cobb County, GA |
| Warrant date: | Oct 14, 2005 |
| Warrant: | 04-720/04-1906 |
| Type: | FI |
| Section: | 42-8-38 |
| Description: | VIOL. OF PROBATION |
| Counts: | 01/ |
| Code: | OCGA |
| Bond amount: | $1,000 |
