| Date of birth: | Jan 3, 1964 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00043099 |
| Booking number: | 2010005357 |
| Booking date: | Sep 17, 2010 |
| Release date: | Sep 20, 2010 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.04 - BAY COUNTY (VOP/BATTERY DOMV) (GIVING FALSE NAME TO LEO) |
| Offense date: | Sep 17, 2010 |
| Bond amount: | $1,731 |
| Arrest date: | Sep 17, 2010 |