| Date of birth: | Nov 14, 1949 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00015907 |
| Booking date: | Jun 15, 2003 |
| Release date: | Jun 15, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.021 - AGGRAVATED ASSAULT W/MOTOR VEH |
| Offense date: | Jun 15, 2003 |
| Bond amount: | $2,500 |