| Date of birth: | Nov 19, 1955 |
| Hair: | Gray |
| Eyes: | Hazel |
| Number: | 00017245 |
| Booking date: | Feb 27, 2004 |
| Release date: | Feb 29, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - VIOLATION OF INJUNCTION OF PROTECTION (WEEKENDER) |
| Offense date: | Feb 27, 2004 |
| Case number: | 2003MM009 |