| Hair: | Black |
| Eyes: | Black |
| SO#: | 57727 |
| Arresting agency: | Lake & Park Police |
| Booking number: | 290776 |
| Booking date: | Jul 20, 2004 |
| Release date: | Oct 13, 2004 |
| Booking location: | Tom Green County, TX |
| Warrant: | 06073429 |
| Offense date: | Jan 1, 1900 |
| Issuing authority: | TDCJ |
| Charge: | PAROLE VIOLATION |