| Date of birth: | May 22, 1959 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00047999 |
| Booking number: | 2012004587 |
| Booking date: | Aug 6, 2012 |
| Release date: | Aug 29, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 741.31-4a - VIOL INJUNCTION PROTECTION DOMESTIC VIOLENCE 2CTS |
| Offense date: | Aug 6, 2012 |
| Case number: | 12MM3478C |
| Bond amount: | $4,000 |