| Date of birth: | Aug 3, 1949 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00013397 |
| Booking date: | Sep 14, 2002 |
| Release date: | Sep 18, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.011 - ASSAULT (SANTA ROSA CO) |
| Offense date: | Sep 14, 2002 |
| Statute: | DEL.9999.999 - HOLD FOR SANTA ROSA |
| Offense date: | Sep 14, 2002 |