| Date of birth: | Jul 14, 1978 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00045361 |
| Booking date: | Aug 9, 2011 |
| Release date: | Aug 9, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a2 - BATTERY DOMV CAUSE BODILY HARM |
| Offense date: | Aug 8, 2011 |
| Bond amount: | $1,000 |