| Date of birth: | Sep 28, 1981 |
| Obts: | 5003296886 |
| Jacket number: | 0407628 |
| Holds for other agencies: | No |
| Arresting agency: | 99 - OTHER |
| Booking date: | Oct 22, 2010 |
| Booking officer: | JASON MELVIN/ DIV OF INSURANCE FRAUD |
| Release date: | Oct 23, 2010 |
| Booking location: | Palm Beach County, FL |
| Description: | FRAUD-USE FALSE ID FOR WC CLAIM LESS THAN 20K DOLS |
| Charge number: | 440.105-5654 |
| Booking number: | 2010052695 |
| Bond amount: | $3,000 |