| Date of birth: | Jun 21, 1963 |
| Hair: | Black |
| Eyes: | Brown |
| Inmate number: | 00021118 |
| Booking number: | 2004007566 |
| Booking date: | Oct 22, 2004 |
| Release date: | Oct 23, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/WC 2CTS |
| Offense date: | Oct 22, 2004 |
| Case number: | 03-MM-10756 |