| Date of birth: | May 26, 1964 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 46933 |
| Booking number: | 2012001994 |
| Booking date: | Apr 12, 2012 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.36-1 - FALSE ID GIVEN TO LEO |
| Offense date: | Apr 12, 2012 |
| Arrest date: | Apr 12, 2012 |