| Date of birth: | Apr 14, 1933 |
| Hair: | Gray |
| Eyes: | Blue |
| Inmate number: | 00012267 |
| Booking number: | 2002003295 |
| Booking date: | Jun 2, 2002 |
| Release date: | Jun 4, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/PETIT THEFT |
| Offense date: | Jun 2, 2002 |
| Case number: | 02-441MM |
| Bond amount: | $200 |