| Date of birth: | Aug 11, 1963 |
| Hair: | Brown |
| Eyes: | Hazel |
| Number: | 00044664 |
| Booking date: | May 8, 2011 |
| Release date: | May 8, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMV |
| Offense date: | May 7, 2011 |
| Bond amount: | $100 |
| Arrest date: | May 7, 2011 |