| Date of birth: | Sep 8, 1961 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00039990 |
| Booking date: | Aug 11, 2009 |
| Release date: | Aug 11, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15-1b - FTA/NVDL |
| Offense date: | Aug 10, 2009 |
| Case number: | 2009CT000413S |
| Arrest date: | Aug 10, 2009 |