| Date of birth: | Mar 9, 1953 |
| Hair: | Brown |
| Eyes: | Hazel |
| Inmate number: | 00019108 |
| Booking number: | 2004002999 |
| Booking date: | Apr 29, 2004 |
| Release date: | May 6, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 941.02 - FFJ/GEORGIA VOP |
| Offense date: | Apr 29, 2004 |