| Date of birth: | Jun 11, 1967 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00019679 |
| Booking number: | 2004004368 |
| Booking date: | Jun 19, 2004 |
| Release date: | Jun 20, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY/DOMV |
| Offense date: | Jun 19, 2004 |
| Bond amount: | $1,000 |