| Date of birth: | Oct 28, 1945 |
| Hair: | Gray |
| Eyes: | Brown |
| Spn: | 171091 |
| Booking location: | Leon County, FL |
| Statute: | 784.03 1A1 |
| Release date: | Nov 10, 2004 |
| Offense date: | Nov 9, 2004 |
| Clerk case: | 2004MM8865A1 |
| Charge literal: | SIMPLE BATTERY |
| Booking date: | Nov 9, 2004 |
| Booking agency: | TALLAHASSEE POLICE DEPARTMENT |
| Agency report: | 04-36772 |