| Date of birth: | Aug 28, 1962 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00019868 |
| Booking number: | 2004004747 |
| Booking date: | Jul 5, 2004 |
| Release date: | Jul 7, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.061 - ACCIDENT INVOLVE DAMAGE TO VEHICLE/PROPERTY-LEAVE SCE |
| Offense date: | Jul 5, 2004 |
| Bond amount: | $500 |