| Date of birth: | Mar 12, 1938 |
| Hair: | Black |
| Eyes: | Brown |
| Inmate number: | 00048447 |
| Booking number: | 2012006014 |
| Booking date: | Oct 8, 2012 |
| Release date: | Nov 2, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 831.02 - DOC 25.1M LARCENY, PASS FORGED INSTRUMENT(6 CTS) |
| Offense date: | Oct 8, 2012 |
| Case number: | 2009CF001646S |
| Arrest date: | Oct 8, 2012 |