| Date of birth: | Jan 3, 1952 |
| Hair: | Gray |
| Eyes: | Hazel |
| Inmate number: | 00020836 |
| Booking number: | 2004006911 |
| Booking date: | Sep 28, 2004 |
| Release date: | Sep 30, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY |
| Offense date: | Sep 28, 2004 |
| Bond amount: | $5,000 |
| Statute: | 784.021 - AGGRAVATED ASSAULT W/WP W/O INTENT TO KILL |
| Offense date: | Sep 28, 2004 |
| Bond amount: | $5,000 |
