| Date of birth: | Jan 30, 1957 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00021772 |
| Booking date: | Dec 24, 2004 |
| Release date: | Dec 24, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - POSS OF ALCOHOL ON CITY PROPERTY (CITY ODR) |
| Offense date: | Dec 24, 2004 |
| Statute: | 843.02 - RESISTING WITHOUT VIOLENCE |
| Offense date: | Dec 24, 2004 |