| Date of birth: | Jun 20, 1932 |
| Hair: | Gray |
| Eyes: | Blue |
| Number: | 00040153 |
| Booking date: | Aug 27, 2009 |
| Release date: | Aug 28, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMV |
| Offense date: | Aug 27, 2009 |
| Bond amount: | $1,000 |
| Arrest date: | Aug 27, 2009 |