| Date of birth: | Apr 3, 1929 |
| Hair: | Gray |
| Eyes: | Blue |
| Number: | 00039317 |
| Booking date: | May 31, 2009 |
| Release date: | May 31, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.08-2c - ON PERSON 65 YEARS OF AGE OR OLDER |
| Offense date: | May 31, 2009 |
| Bond amount: | $500 |
| Arrest date: | May 31, 2009 |