| Date of birth: | Oct 27, 1966 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00018966 |
| Booking date: | Apr 15, 2004 |
| Release date: | Apr 15, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/GT(ESCAMBIA COUNTY) |
| Offense date: | Apr 15, 2004 |
| Case number: | 034485CIR |
| Statute: | DEL.9999.999 - HOLD FOR ESCAMBIA COUNTY |
| Offense date: | Apr 15, 2004 |