| Date of birth: | Oct 22, 1958 |
| Hair: | Brown |
| Eyes: | Hazel |
| Residency: | Resident |
| Marital status: | Married |
| Juvenile: | No |
| Employment: | DELI |
| Employer school: | PUBLIX |
| Education: | 10TH |
| Dl number: | D400-735-58-882-0 |
| Citizen: | Y |
| Birth place: | EVERETT, WASHINGTON |
| Apt unit: | LOT 17 |
| Booking location: | Charlotte County, FL |
| Statute description: | CRIMINAL REGISTRATION (NOT AN ARREST) / |
| Statute: | 775.13 |
| Offense date: | Sep 15, 2011 |
| Obts number: | 0801067688 |
| Level: | N |
| Charge: | N |
| Bond amount: | $0 |
| Arresting officer: | CRIMINAL REGISTRANT - NOT AN ARREST |
| Arrest location: | CHARLOTTE COUNTY JAIL |
| Agency: | FL0080000 |
