| Date of birth: | Dec 11, 1952 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00019605 |
| Booking number: | 2004004197 |
| Booking date: | Jun 13, 2004 |
| Release date: | Jun 17, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 812.014.2B - GRAND THEFT (20,000 DLS) |
| Offense date: | Jun 13, 2004 |
| Case number: | 04CF1327S |
| Bond amount: | $2,500 |