| Date of birth: | 1964 |
| SO#: | 001019320 |
| Serial number: | 000847419 |
| Birth place: | KY |
| Agency id: | GA0330000 |
| Arresting agency: | GA0330000-COBB CO SHERIFF |
| Arrest date: | May 9, 2014 |
| Arrest location: | COSTCO CUMBERLAND MALL |
| Arrest officer: | S13038 |
| Booking date: | May 9, 2014 |
| Booking location: | Cobb County, GA |