| Date of birth: | Jun 11, 1960 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00045220 |
| Booking date: | Jul 21, 2011 |
| Release date: | Aug 2, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-2 - BATTERY 2ND OR SUBSQ OFF DOMV |
| Offense date: | Jul 20, 2011 |
| Case number: | 11CF1379C |
| Bond amount: | $2,000 |
| Arrest date: | Jul 20, 2011 |