| Date of birth: | Apr 4, 1950 |
| Hair: | Gray |
| Eyes: | Brown |
| Inmate number: | 00017549 |
| Booking number: | 2003007337 |
| Booking date: | Nov 22, 2003 |
| Release date: | Nov 22, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY(DOMV) |
| Offense date: | Nov 22, 2003 |