| Booking number: | 0191301199 |
| Booking date: | Jul 24, 2013 |
| Release date: | Jul 24, 2013 |
| Jail name: | Bedford Adult Detention Facility |
| Location: | 1000 Broad St, Bedford, VA 24523 |
| Statute: | 18.2-308.2:2(K) |
| Description: | FALSE STATEMENT ON FIREARM CONSENT FORM |
| Offense date: | Jun 8, 2013 |
| Arrest date: | Jul 24, 2013 |
| Bond amount: | $3,500 |