| Date of birth: | Mar 23, 1923 |
| Hair: | Grey or partially grey |
| Eyes: | Brown |
| SO#: | 111557 |
| Arresting agency: | Other Agency |
| Booking number: | 195861 |
| Booking date: | Dec 9, 2002 |
| Release date: | Dec 10, 2002 |
| Booking location: | Brazoria County, TX |
| Warrant: | HJ004274 |
| Issuing authority: | 000001 |
| Fine or court cost: | $200 |
| Charge: | ASSAULT BY CONTACT F/V |