| Date of birth: | Jun 30, 1964 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00019422 |
| Booking date: | May 29, 2004 |
| Release date: | Jun 1, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 810.09 - TRESPASS PROPERTY OTHER THAN STRUCTURE/CONVEYANCE |
| Offense date: | May 29, 2004 |
| Bond amount: | $500 |