| Date of birth: | Nov 27, 1958 |
| Hair: | Brown |
| Eyes: | Green |
| Inmate number: | 00019143 |
| Booking number: | 2004003090 |
| Booking date: | May 2, 2004 |
| Release date: | May 26, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 812.014.2D - THEFT |
| Offense date: | May 2, 2004 |
| Case number: | 04MM1428 |