| Date of birth: | Mar 12, 1948 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00047903 |
| Booking number: | 2012006804 |
| Booking date: | Nov 14, 2012 |
| Release date: | Nov 15, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WC |
| Offense date: | Nov 14, 2012 |
| Case number: | 12MM4608C |
| Arrest date: | Nov 14, 2012 |