| Date of birth: | Aug 30, 1967 |
| Hair: | Brown |
| Eyes: | Green |
| Number: | 00040478 |
| Booking date: | Oct 4, 2009 |
| Release date: | Oct 5, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 832.05-2 - WC |
| Offense date: | Oct 3, 2009 |
| Bond amount: | $335 |
| Arrest date: | Oct 3, 2009 |