| Date of birth: | Jan 2, 1969 |
| Hair: | Brown |
| Eyes: | Green |
| Number: | 00042749 |
| Booking date: | Jul 28, 2010 |
| Release date: | Jul 30, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY/DOMV |
| Offense date: | Jul 27, 2010 |
| Bond amount: | $1,000 |
| Arrest date: | Jul 27, 2010 |