| Date of birth: | Aug 13, 1975 |
| Hair: | Brown |
| Eyes: | Blue |
| Number: | 00019227 |
| Booking date: | May 11, 2004 |
| Release date: | May 11, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - ESCAMBIA(FTA/DWLSR) |
| Offense date: | May 11, 2004 |
| Case number: | 4895BPHTFC |
| Bond amount: | $2,000 |