| Date of birth: | Sep 26, 1970 |
| Hair: | Brown |
| Eyes: | Blue |
| Number: | 00020987 |
| Booking date: | Oct 12, 2004 |
| Release date: | Oct 12, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY (DOMV) |
| Offense date: | Oct 12, 2004 |
| Statute: | 843.02 - RESIST OFFICER WITHOUT VIOLENCE |
| Offense date: | Oct 12, 2004 |