| Date of birth: | Mar 25, 1966 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00015496 |
| Booking number: | 2004007282 |
| Booking date: | Oct 11, 2004 |
| Release date: | Oct 12, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/ DWLSR |
| Offense date: | Oct 11, 2004 |
| Case number: | 04CT652C |
| Bond amount: | $250 |
