| Date of birth: | 1959 |
| Hair: | Gray |
| Eyes: | Green |
| SO#: | 000030297 |
| Releasing officer: | 086004 |
| Duration of custody: | 1 |
| Comments: | OTN/118204365 W/G FLV |
| Birth place: | GA |
| Arresting agency: | GA0330000 |
| Arrest number: | 000445951 |
| Arrest date: | Sep 25, 2004 |
| Arrest location: | WALMART 2911 BUSBEE PKWY |
| Booking date: | Sep 25, 2004 |
| Booking officer: | 096028 |
| Booking location: | Cobb County, GA |
| Warrant date: | Sep 25, 2004 |
| Warrant: | 04-W-10381 |
| Type: | FU |
| Section: | 16-8-14 |
| Offense date: | Sep 25, 2004 |
| Description: | THEFT BY SHOPLIFTING |
| Counts: | 01/ |
| Code: | OCGA |
| Bond amount: | $5,000 |
