| Date of birth: | Dec 9, 1931 |
| Hair: | Bald |
| Eyes: | Brown |
| Residency: | Resident |
| Marital status: | Married |
| Juvenile: | No |
| Employment: | RETIRED |
| Education: | 11TH GRADE |
| Dl number: | L325820314490 |
| Citizen: | Y |
| Birth place: | NEW YORK |
| Apt unit: | 607 |
| Booking location: | Charlotte County, FL |
| Statute description: | RETAIL THEFT |
| Statute: | 812.014 3a |
| Offense date: | Feb 16, 2004 |
| Oca number: | 04004573 |
| Obts number: | 0801013363 |
| Level: | S |
| Depositer name: | CRENSHAW, DEBRA |
| Court date: | Mar 3, 2004 |
| Charge: | M |
| Bond amount: | $500 |
| Bond agency: | BLANDING BAIL BONDS |
| Arresting officer: | BRIGHTMAN, KEVIN |
| Arrest location: | 2000 KINGS HWY (WINN DIXIE) |
| Agency: | FL0080000 |