| Date of birth: | Jun 17, 1935 |
| Hair: | Gray |
| Eyes: | Hazel |
| Inmate number: | 00015934 |
| Booking number: | 2003003599 |
| Booking date: | Jun 17, 2003 |
| Release date: | Jun 18, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY/ DOMV |
| Offense date: | Jun 17, 2003 |