| Date of birth: | Apr 1, 1959 |
| Hair: | Gray |
| Eyes: | Blue |
| Inmate number: | 00048497 |
| Booking number: | 2012006156 |
| Booking date: | Oct 15, 2012 |
| Release date: | Oct 15, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY-DOMV |
| Offense date: | Oct 14, 2012 |
| Case number: | 1210936 |
| Bond amount: | $1,000 |
| Arrest date: | Oct 14, 2012 |