| Date of birth: | May 12, 1942 |
| Hair: | Gray |
| Eyes: | Brown |
| Number: | 00041459 |
| Booking date: | Feb 10, 2010 |
| Release date: | Feb 10, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WC |
| Offense date: | Feb 10, 2010 |
| Case number: | 4609MM013040 |
| Bond amount: | $374 |
| Arrest date: | Feb 10, 2010 |