| Date of birth: | 1957 |
| Hair: | Brown |
| Eyes: | Hazel |
| SO#: | 000020667 |
| Releasing officer: | 091034 |
| Duration of custody: | 12 |
| Comments: | W/G:HALL OTN/NA |
| Birth place: | GA |
| Type: | OT |
| Side: | X |
| Description: | STITCHES ON REAR IN |
| Body part: | O |
| Type: | 09 |
| Side: | X |
| Description: | ROSE |
| Body part: | A |
| Type: | 02 |
| Side: | X |
| Description: | PINK PANTHER |
| Body part: | A |
| Arresting agency: | GA0330000 |
| Arrest number: | 000445721 |
| Arrest date: | Sep 23, 2004 |
| Arrest location: | JACKSON/DODGE ST PRISON |
| Booking date: | Sep 23, 2004 |
| Booking officer: | 097076 |
| Booking location: | Cobb County, GA |
| Type: | NC |
| Section: | HOLD |
| Description: | HOLD OTHER AGENCY |
| Code: | HOLD |
| Bond amount: | No bail |
| Warrant date: | Sep 21, 2004 |
| Warrant: | 04-1-5292-28 |
| Type: | FI |
| Section: | FOR COURT |
| Description: | RETURN FOR COURT |
| Counts: | 01/ |
| Code: | CT |
| Bond amount: | No bail |
