| Booking number: | 6801501852 |
| Booking date: | May 17, 2015 |
| Release date: | May 17, 2015 |
| Jail name: | Lynchburg Adult Detention Center |
| Location: | 510 9 St, Lynchburg, VA 24504 |
| Statute: | 18.2-308.2:2(K) |
| Description: | FALSE STATEMENT ON FIREARM CONSENT FORM |
| Offense date: | Apr 17, 2014 |
| Arrest date: | May 17, 2015 |
