| Date of birth: | May 25, 1971 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00040907 |
| Booking date: | Nov 28, 2009 |
| Release date: | Nov 30, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.13-6a - POM+20 |
| Offense date: | Nov 28, 2009 |
| Bond amount: | $3,000 |
| Arrest date: | Nov 28, 2009 |
| Statute: | 893.147-1 - POP |
| Offense date: | Nov 28, 2009 |
| Bond amount: | $1,000 |
| Arrest date: | Nov 28, 2009 |
