| Date of birth: | Apr 3, 1956 |
| Report: | 2004-25173/1 |
| Arrest date: | Nov 23, 2004 |
| Arrest location: | 7793 INDIAN TRAIL RD |
| Booking location: | Hernando County, FL |
| Description: | 784.03 - DOMESTIC BATTERY |
| Description: | 784.011 - ASSAULT |
| Description: | 914.22 - TAMPER/HARASS WITNESS-VICTIM |