| Date of birth: | Apr 28, 1954 |
| Hair: | Gray |
| Eyes: | Brown |
| Inmate number: | 00047913 |
| Booking number: | 2012004366 |
| Booking date: | Jul 28, 2012 |
| Release date: | Jul 28, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMESTIC VIOLENCE- TOUCH OR STRIKE |
| Offense date: | Jul 27, 2012 |
| Arrest date: | Jul 27, 2012 |