| Date of birth: | Mar 11, 1983 |
| Hair: | Brown |
| Eyes: | Brown |
| Unit description: | 4 E. Main St, P.O. Box 427, Black River Falls, WI 54615-0066, (715)284-4747 |
| Unit: | 5 07 |
| Pin number: | 900012 |
| Photo date: | Dec 6, 2011 |
| Booking number: | 00582852 |
| Booking location: | Clark County, WI |
| Statute: | 940.19(1) M |
| County: | CLARK |
| Convicted: | Nov 18, 2011 |
| Case number: | 11CM110 |