| Date of birth: | Jul 15, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00043550 |
| Booking date: | Dec 4, 2010 |
| Release date: | Dec 5, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.04 - BAY CO/BATTERY |
| Offense date: | Dec 4, 2010 |
| Case number: | 08005849MM0 |
| Bond amount: | $2,500 |
| Arrest date: | Dec 4, 2010 |