| Date of birth: | Jun 16, 1956 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00047504 |
| Booking number: | 2012003205 |
| Booking date: | Jun 9, 2012 |
| Release date: | Jun 9, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 806.13-1b2 - MISD CRIM MISC |
| Offense date: | Jun 9, 2012 |
| Bond amount: | $1,000 |
| Arrest date: | Jun 9, 2012 |