| Date of birth: | Nov 14, 1950 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00046453 |
| Booking number: | 2012000280 |
| Booking date: | Jan 17, 2012 |
| Release date: | Jan 17, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMV |
| Offense date: | Jan 16, 2012 |
| Bond amount: | $1,000 |
| Arrest date: | Jan 16, 2012 |