| Date of birth: | Mar 29, 1952 |
| Hair: | Brown |
| Eyes: | Green |
| Number: | 00019176 |
| Booking date: | May 7, 2004 |
| Release date: | May 7, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 812.014 - GRAND THEFT OVER 10,000 |
| Offense date: | May 7, 2004 |
| Bond amount: | $7,000 |
| Statute: | 918.13 - TAMPER WITH/FABRICATE EVIDENCE |
| Offense date: | May 7, 2004 |
| Bond amount: | $7,000 |
