| Date of birth: | May 27, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00039717 |
| Booking date: | Jul 10, 2009 |
| Release date: | Jul 11, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.147-1 - POP |
| Offense date: | Jul 10, 2009 |
| Bond amount: | $500 |
| Arrest date: | Jul 10, 2009 |