| Date of birth: | 1981 |
| Unit description: | 922 Churchill St; Waupaca, WI 54981-2089; (715)258-4620 |
| Unit: | 4 07 |
| Pin number: | 880931 |
| Photo date: | Jun 28, 2011 |
| Booking number: | 00575619 |
| Booking location: | Polk County, WI |
| Statute: | 941.23 M , 941.237(2) M |
| County: | WAUPACA |
| Convicted: | Jun 28, 2011 |
| Case number: | 11CM97 |