| Date of birth: | Jun 10, 1943 |
| Hair: | Brown |
| Eyes: | Green |
| Number: | 00042476 |
| Booking date: | Jun 22, 2010 |
| Release date: | Jun 22, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.04 - WASHINGTON CO/FTA-FAIL TO PAY INFRACTION |
| Offense date: | Jun 22, 2010 |
| Case number: | 97-01072MM |
| Bond amount: | $150 |
| Arrest date: | Jun 22, 2010 |