| Date of birth: | Oct 26, 1939 |
| Hair: | Gray |
| Eyes: | Blue |
| Inmate number: | 00045481 |
| Booking number: | 2011004773 |
| Booking date: | Aug 21, 2011 |
| Release date: | Aug 22, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMV |
| Offense date: | Aug 21, 2011 |
| Bond amount: | $1,000 |
| Arrest date: | Aug 21, 2011 |