| Date of birth: | Jun 16, 1943 |
| Hair: | Gray |
| Eyes: | Hazel |
| Inmate number: | 00049108 |
| Booking number: | 2013000162 |
| Booking date: | Jan 8, 2013 |
| Release date: | Jan 8, 2013 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - DOMV BATTERY |
| Offense date: | Jan 8, 2013 |
| Bond amount: | $1,000 |