| Date of birth: | Aug 2, 1965 |
| Hair: | Gray |
| Eyes: | Brown |
| Number: | 00043325 |
| Booking date: | Oct 24, 2010 |
| Release date: | Oct 24, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY (DOMV) |
| Offense date: | Oct 23, 2010 |
| Case number: | 10-10089 |
| Arrest date: | Oct 23, 2010 |