| Date of birth: | Feb 12, 1955 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00039408 |
| Booking date: | Jun 10, 2009 |
| Release date: | Jun 11, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WC (5 COUNTS) |
| Offense date: | Jun 10, 2009 |
| Case number: | 4607MM14690A-14692A |
| Arrest date: | Jun 10, 2009 |