| Date of birth: | Jul 14, 1984 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00021441 |
| Booking number: | 2004008350 |
| Booking date: | Nov 21, 2004 |
| Release date: | Nov 21, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.212.5 - ALTERED DL |
| Offense date: | Nov 21, 2004 |
| Bond amount: | $250 |