| Date of birth: | Jun 5, 1952 |
| Hair: | Brown |
| Eyes: | Blue |
| Number: | 00011977 |
| Booking date: | Oct 26, 2002 |
| Release date: | Nov 24, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/POM |
| Offense date: | Oct 26, 2002 |
| Case number: | 02-1327MMS |
| Bond amount: | $600 |