| Date of birth: | Oct 14, 1957 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00019509 |
| Booking date: | Jun 5, 2004 |
| Release date: | Jun 6, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.13 - POCS(COCAINE) |
| Offense date: | Jun 5, 2004 |
| Case number: | 04-5982 |
| Bond amount: | $2,500 |