| Date of birth: | Jul 10, 1929 |
| Hair: | Brown |
| Eyes: | Blue |
| Number: | 00013367 |
| Booking date: | Sep 10, 2002 |
| Release date: | Sep 10, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - MAKING FALSE REPORT |
| Offense date: | Sep 10, 2002 |
| Bond amount: | $1,000 |