| Date of birth: | Dec 29, 1945 |
| Hair: | Gray |
| Eyes: | Brown |
| Photo date: | May 29, 2004 |
| Id number: | 201577 |
| Arrest date: | May 29, 2004 |
| Booking number: | 344557 |
| Release date: | May 30, 2004 |
| Booking location: | Lee County, FL |
| Type: | Misdemeanor |
| Description: | FRAUD-IMPERSON/FALSE ID GIVEN TO LEO |
| Court: | County Court |
| Case number: | 04021751MM |
| Agency: | FMPD |