| Date of birth: | Jun 24, 1948 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00041191 |
| Booking date: | Jan 5, 2010 |
| Release date: | Jan 5, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WALTON COUNTY/WORTHLESS CHECK |
| Offense date: | Jan 5, 2010 |
| Case number: | 6607MM005945A |
| Bond amount: | $273 |
| Arrest date: | Jan 5, 2010 |