| Date of birth: | 1963 |
| Committed by: | ELLIS |
| Arrest officer: | STATE POLICE |
| Booking number: | 04-01517 |
| Booking date: | Jul 23, 2004 |
| Release date: | Jul 23, 2004 |
| Booking location: | Washington County, PA |
| Description: | SIMPLE ASSAULT |
| Description: | RESIST ARREST/OTHER LAW ENFORCE |
| Description: | HARASSMENT/STRIKE, SHOVE, KICK, ETC. |
| Description: | $5,000.00 - STRAIGHT BOND |