| Date of birth: | 1947 |
| Hair: | Gray |
| Eyes: | Brown |
| SO#: | 000050910 |
| Releasing officer: | 002757 |
| Duration of custody: | 1 |
| Comments: | A/T:MAZARIEGOS OTN:112978423 PROP 550 GCIC//GOSS |
| Birth place: | GA |
| Arresting agency: | GA0330000 |
| Arrest number: | 000443257 |
| Arrest date: | Aug 29, 2004 |
| Arrest location: | SMYRNA PD |
| Booking date: | Aug 29, 2004 |
| Booking officer: | 000216 |
| Booking location: | Cobb County, GA |
| Warrant date: | Aug 29, 2004 |
| Warrant: | 04-W-9272 |
| Type: | MU |
| Section: | 16-5-23 |
| Offense date: | Aug 29, 2004 |
| Description: | SIMPLE BATTERY |
| Counts: | 01/ |
| Code: | OCGA |
| Bond amount: | $1,000 |
| Warrant: | 04-W-9272 |
| Type: | MU |
| Section: | 16-10-24.3 |
| Description: | OBST OF 911 CALL |
| Counts: | 01/ |
| Code: | OCGA |
| Bond amount: | $0 |
