| Date of birth: | Apr 13, 1942 |
| Hair: | Brown |
| Eyes: | Brown |
| Spn: | 316 |
| Booking location: | Leon County, FL |
| Statute: | 440.105 |
| Release date: | Jun 22, 2000 |
| Offense date: | May 11, 1999 |
| Clerk case: | 2000CF2324A1 |
| Charge literal: | WORKERS COMPENSATION FRAUD |
| Booking date: | Jun 22, 2000 |
| Booking agency: | LEON COUNTY SHERIFF TALLAHASSEE |
| Agency report: | SO00103546 |