| Date of birth: | Apr 16, 1954 |
| Hair: | Gray |
| Eyes: | Green |
| Number: | 00039459 |
| Booking date: | Jun 15, 2009 |
| Release date: | Jun 15, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY (DOMV) |
| Offense date: | Jun 15, 2009 |
| Bond amount: | $2,500 |
| Arrest date: | Jun 15, 2009 |