| Date of birth: | Jun 11, 1957 |
| Hair: | Black |
| Eyes: | Brown |
| Inmate number: | 00040354 |
| Booking number: | 2009005820 |
| Booking date: | Sep 18, 2009 |
| Release date: | Sep 19, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 817.037 - RBB/FRAUD; CRIME OF ID INFO |
| Offense date: | Sep 18, 2009 |
| Case number: | 09CF1222S |
| Bond amount: | $2,000 |
| Arrest date: | Sep 18, 2009 |