| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 66238 |
| Arresting agency: | San Angelo Police Department |
| Booking number: | 285790 |
| Booking date: | Jan 18, 2004 |
| Release date: | Jan 18, 2004 |
| Booking location: | Tom Green County, TX |
| Warrant: | O/S 04-00496L2 |
| Offense date: | Jan 18, 2004 |
| Issuing authority: | TOM GREEN |
| Fine or court cost: | $200 |
| Charge: | ASSAULT CAUSES BODILY INJURY FAMILY VIOLENCE |