| Date of birth: | Jul 22, 1961 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00018953 |
| Booking number: | 2004002577 |
| Booking date: | Apr 13, 2004 |
| Release date: | Apr 19, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - PASCO CO(VOP/GT) |
| Offense date: | Apr 13, 2004 |
| Case number: | 9100602CFAWS |