| Date of birth: | Jul 21, 1969 |
| Hair: | Brown |
| Eyes: | Blue |
| Number: | 00019078 |
| Booking date: | Apr 26, 2004 |
| Release date: | Apr 26, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 877.03 - BREACH OF PEACE/DISORDERLY CONDUCT/FIGHTING/BRAWLING |
| Offense date: | Apr 26, 2004 |
| Bond amount: | $250 |