| Date of birth: | Jun 23, 1953 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00018173 |
| Booking number: | 2004000613 |
| Booking date: | Jan 26, 2004 |
| Release date: | Jan 27, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/ORIGINAL CHARGE FTA/NO DRIVERS LICENSE |
| Offense date: | Jan 26, 2004 |
| Case number: | 2003CT2339S |
| Bond amount: | $156 |