| Date of birth: | Sep 13, 1967 |
| Hair: | Brown |
| Eyes: | Green |
| Number: | 00042374 |
| Booking date: | Jun 9, 2010 |
| Release date: | Jun 14, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.04 - BAY CO/FTA/PT |
| Offense date: | Jun 9, 2010 |
| Case number: | 09005408MMMA |
| Arrest date: | Jun 9, 2010 |