| Date of birth: | Dec 3, 1975 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00021473 |
| Booking date: | Nov 25, 2004 |
| Release date: | Dec 29, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.192 - RD/DWLSR/LSOA |
| Offense date: | Nov 25, 2004 |
| Case number: | 04CT3890S |
| Statute: | 941.02 - FFJ SC/VIOL PAROLE |
| Offense date: | Nov 25, 2004 |