| Obts number: | 5003314633 |
| Jacket number: | 0424366 |
| Holds for other agencies: | No |
| Facility: | OWN RECOGNIZANCE |
| Arresting agency: | 99-OTHER |
| Booking number: | 2011038954 |
| Booking date: | Aug 25, 2011 |
| Booking officer: | JASON MELVIN |
| Release date: | Aug 26, 2011 |
| Booking location: | Palm Beach County, FL |
| Description: | FRAUD-FALSE STATEMENT - MISREP OMIT INF RE W/C CLAIM LESS 20K DOLS |
| Charge number: | 440.105-990 |
| Bond amount: | $0 |