| Date of birth: | Mar 16, 1952 |
| Hair: | Bald |
| Eyes: | Green |
| Inmate number: | 00047100 |
| Booking number: | 2012007161 |
| Booking date: | Dec 3, 2012 |
| Release date: | Dec 4, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMV |
| Offense date: | Dec 3, 2012 |
| Bond amount: | $1,000 |
| Arrest date: | Dec 3, 2012 |