| Date of birth: | 1966 |
| Hair: | Brown |
| Eyes: | Blue |
| Unit description: | 4 E. Main St; P.O. Box 427; Black River Falls, WI 54615-0066; (715)284-4747 |
| Unit: | 5 07 |
| Pin number: | 858061 |
| Photo date: | Nov 16, 2010 |
| Booking number: | 00566557 |
| Booking location: | Polk County, WI |
| Statute: | 939.63(1)(A) , 947.01 M |
| County: | CLARK |
| Convicted: | Nov 16, 2010 |
| Case number: | 10CM68 |