| Hair: | Grey or partially grey |
| Eyes: | Green |
| SO#: | 11640 |
| Arresting agency: | San Angelo Police Department |
| Booking number: | 287504 |
| Booking date: | Mar 21, 2004 |
| Release date: | Mar 22, 2004 |
| Booking location: | Tom Green County, TX |
| Warrant: | 96021202 |
| Offense date: | Jan 1, 1900 |
| Issuing authority: | 04-M00449 |
| Fine or court cost: | $236 |
| Charge: | CPF X 2 |