| Date of birth: | Feb 2, 1941 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00013166 |
| Booking date: | Aug 26, 2002 |
| Release date: | Aug 26, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/NVDL |
| Offense date: | Aug 26, 2002 |
| Case number: | 01-822 |
| Bond amount: | $150 |