| Date of birth: | Jun 9, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00042511 |
| Booking date: | Jun 28, 2010 |
| Release date: | Jun 29, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY (DOMV) |
| Offense date: | Jun 27, 2010 |
| Bond amount: | $1,000 |
| Arrest date: | Jun 27, 2010 |