| Date of birth: | Jan 7, 1926 |
| Hair: | Grey |
| Eyes: | Brown |
| Marital status: | Other |
| Juvenile: | No |
| Employment: | 10 UNKNOWN OR NOT STATED |
| Education: | 12 |
| Dl number: | B525470260070 |
| Citizen: | Y |
| Birth place: | RH |
| Booking location: | Charlotte County, FL |
| Statute description: | CRIMINAL REGISTRATION |
| Statute: | CRM-1 |
| Offense date: | Apr 2, 2001 |
| Obts number: | 9036904 |
| Arresting officer: | BARLOW, ROBERT |
| Arrest location: | CCSO JAIL |
| Agency: | FL0080000 |