| Date of birth: | Jun 18, 1954 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 204884 |
| Booking number: | 2004050089 |
| Booking date: | May 4, 2004 |
| Release date: | Jun 14, 2004 |
| Booking location: | Santa Fe County, NM |
| Statute description: | VIOLATION OF ORDER OF PROTECTION M49MR200400355D |
| Statute: | 40-13-6 |
| Charge number: | 1 |
| Bond amount: | $5,000 #1 |