| Date of birth: | May 15, 1964 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00009761 |
| Booking date: | May 23, 2011 |
| Release date: | Jun 15, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY- DOMV |
| Offense date: | May 22, 2011 |
| Case number: | 11MM1742S |
| Statute: | 843.02 - OBSTRUCT WO VIOLENCE |
| Offense date: | May 22, 2011 |
| Case number: | 11MM1742S |