| Date of birth: | Aug 19, 1972 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00043720 |
| Booking date: | Jan 4, 2011 |
| Release date: | Jan 7, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03-1a1 - BATTERY DOMV |
| Offense date: | Jan 4, 2011 |
| Bond amount: | $5,000 |
| Arrest date: | Jan 4, 2011 |