| Date of birth: | Jan 5, 1959 |
| Obts: | 5001031632 |
| Jacket number: | 0428749 |
| Holds for other agencies: | No |
| Facility: | SURETY BOND |
| Arresting agency: | 01-PBSO |
| Booking number: | 2011057246 |
| Booking date: | Dec 23, 2011 |
| Release date: | Dec 23, 2011 |
| Booking location: | Palm Beach County, FL |
| Description: | FRAUD-FALSE STATEMENT - MAKE FALSE ENTRY RE FINAN CONDITION |
| Charge number: | 817.2341-5344 |
| Bond amount: | $3,000 |