| Date of birth: | Sep 14, 1964 |
| Jacket number: | 0459422 |
| Holds for other agencies: | No |
| Arresting agency: | 01-PBSO |
| Booking number: | 2014031083 |
| Booking date: | Jul 30, 2014 |
| Booking location: | Palm Beach County, FL |
| Statute: | 440.105-990 |
| Charge: | FRAUD-FALSE STATEMENT - MISREP OMIT INF RE W/C CLAIM LESS 20K DOLS |
| Bond amount: | $3,000 |