| Date of birth: | Oct 1, 1950 |
| Hair: | Gray |
| Eyes: | Blue |
| Inmate number: | 00044876 |
| Booking number: | 2011003208 |
| Booking date: | Jun 4, 2011 |
| Release date: | Jun 4, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY (DOMV) |
| Offense date: | Jun 4, 2011 |
| Bond amount: | $1,500 |
| Arrest date: | Jun 4, 2011 |