| Date of birth: | Aug 6, 1959 |
| Hair: | Salt/pepper |
| Eyes: | Brown |
| Inmate number: | 00021085 |
| Booking number: | 2004007478 |
| Booking date: | Oct 18, 2004 |
| Release date: | Oct 26, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY(DOMV) |
| Offense date: | Oct 18, 2004 |
| Case number: | 04MM3572 |