| Date of birth: | 1952 |
| Hair: | Grey/partly grey |
| Eyes: | Brown |
| Jacket number: | 13161 |
| Inmate classification: | AWAIT SENT |
| Badge: | 3965 |
| Arresting agency: | PROVIDENCE POLICE DEPARTMENT |
| Arrest number: | 958111 |
| Arrest date: | Jun 20, 2013 |
| Booking date: | Jun 20, 2013 |
| Booking location: | Webster County, KY |
| Control number: | AZ82803 |
| Charge number: | 35199 |
| Charge description: | ASSAULT, 4TH DEGREE (NO VISIBLE INJURY) |
| Arrest code: | 00795 |