| Date of birth: | Jan 15, 1950 |
| Hair: | Gray |
| Eyes: | Hazel |
| Inmate number: | 00022115 |
| Booking number: | 2005000594 |
| Booking date: | Jan 20, 2005 |
| Release date: | Jan 21, 2005 |
| Booking location: | Okaloosa County, FL |
| Statute: | 941.02 - FFJ MI/ CHILD SUPPORT |
| Offense date: | Jan 20, 2005 |
| Case number: | 03-34069 |
| Bond amount: | $30,000 |