| Date of birth: | Feb 27, 1955 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00006979 |
| Booking number: | 2004001495 |
| Booking date: | Mar 3, 2004 |
| Release date: | Mar 10, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - BAY COUNTY VOP/PASSING W/C'S 7CTS/ BAY CO. |
| Offense date: | Mar 3, 2004 |
| Case number: | 00-9209-MMMW |
| Bond amount: | $2,500 |