| Date of birth: | Sep 13, 1965 |
| Hair: | Brown |
| Eyes: | Hazel |
| Number: | 00045690 |
| Booking date: | Sep 24, 2011 |
| Release date: | Sep 25, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY / TOUCH OR STRIKE / DOMV |
| Offense date: | Sep 24, 2011 |
| Bond amount: | $500 |
| Statute: | 893.13-6a - POSSESS / CNTRL SUB WO PRESCRIPTION |
| Offense date: | Sep 24, 2011 |
| Bond amount: | $2,500 |