| Date of birth: | May 24, 1952 |
| Hair: | Gray |
| Eyes: | Brown |
| Photo date: | Sep 8, 2004 |
| Id number: | 204522 |
| Arrest date: | Sep 8, 2004 |
| Booking number: | 355036 |
| Release date: | Sep 10, 2004 |
| Booking location: | Lee County, FL |
| Type: | Felony |
| Description: | OUT-OF-STATE-FUG-REF/NORTH CAROLINA STATE |
| Court: | County Court |
| Case number: | BK-355036 |
| Agency: | CCPD |