| Date of birth: | Mar 3, 1935 |
| Hair: | Brown |
| Eyes: | Brown |
| Spn: | 16021 |
| Booking location: | Leon County, FL |
| Statute: | 941.02 |
| Release date: | May 10, 2004 |
| Offense date: | Mar 3, 2004 |
| Clerk case: | 2004CF846A1 |
| Charge literal: | FUGITIVE HOLD/GA. STATE BOARD OF PARDONS AND PAROLE |
| Booking date: | Mar 3, 2004 |
| Booking agency: | TALLAHASSEE POLICE DEPARTMENT |
| Agency report: | 04-7344 |