| Date of birth: | Mar 10, 1949 |
| Hair: | Gray |
| Eyes: | Brown |
| Number: | 00041631 |
| Booking date: | Mar 5, 2010 |
| Release date: | Mar 6, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15-1a - FTA/DWLSR |
| Offense date: | Mar 5, 2010 |
| Case number: | 2010CT000173-S |
| Arrest date: | Mar 5, 2010 |