| Date of birth: | Feb 27, 1954 |
| Hair: | Gray |
| Eyes: | Brown |
| Number: | 00040682 |
| Booking date: | Oct 31, 2009 |
| Release date: | Oct 31, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WC |
| Offense date: | Oct 31, 2009 |
| Case number: | 4609MM012900A |
| Arrest date: | Oct 31, 2009 |