| Date of birth: | Jul 22, 1950 |
| Hair: | Brown |
| Eyes: | Hazel |
| Number: | 00016287 |
| Booking date: | Jul 20, 2003 |
| Release date: | Aug 3, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 941.02 - FFJ/GEORGIA |
| Offense date: | Jul 20, 2003 |
| Statute: | DEL.9999.999 - HOLD FOR GEORGIA |
| Offense date: | Jul 20, 2003 |