| Date of birth: | Apr 11, 1970 |
| Hold: | no |
| Arresting agency: | HAINES CITY POLICE DEPT. |
| Booking number: | 2004-008341 |
| Booking date: | Apr 10, 2004 |
| Release date: | Apr 23, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 901.36(1) FRAUD-IMPERSON-FALSE ID GIVEN TO LEO |
| Charge on arrest docket: | FALSE ID TO LEO |
| Charge number: | 1 |