| Date of birth: | Apr 12, 1943 |
| Hair: | Gray |
| Eyes: | Hazel |
| Number: | 00042061 |
| Booking date: | Apr 27, 2010 |
| Release date: | Apr 27, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WC |
| Offense date: | Apr 27, 2010 |
| Bond amount: | $340 |
| Arrest date: | Apr 27, 2010 |