| Date of birth: | 1959 |
| Hair: | Blond |
| Eyes: | Blue |
| SO#: | 001013185 |
| Serial number: | 000831860 |
| Releasing officer: | S10017 |
| Birth place: | MIN |
| Agency id: | GA0330200 |
| Arresting agency: | GA0330200-COBB CO PD |
| Arrest date: | Sep 19, 2013 |
| Arrest location: | 3350 GEORGE BUSBE PKWY APT 107 |
| Arrest officer: | S07037 |
| Booking date: | Sep 19, 2013 |
| Booking location: | Cobb County, GA |