| Date of birth: | Mar 26, 1956 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00043773 |
| Booking date: | Jan 12, 2011 |
| Release date: | Jan 12, 2011 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.04 - OUT OF CO WRT/ BAY CO/ GT |
| Offense date: | Jan 11, 2011 |
| Case number: | 10-3698C |