| Date of birth: | 1951 |
| Hair: | Xxx |
| Eyes: | Brown |
| SO#: | 000010102 |
| Releasing officer: | 003603 |
| Duration of custody: | 15 |
| Comments: | A/T: S E VAN OMEN W/G:CMOORE PROP# 993 |
| Birth place: | GA |
| Type: | OT |
| Side: | R |
| Description: | PLATE & SCREWS/ANKLE |
| Body part: | F |
| Type: | OT |
| Side: | R |
| Description: | FRONT TOOTH MISSING |
| Body part: | X |
| Arresting agency: | GA0330200 |
| Arrest number: | 000714782 |
| Arrest date: | Jun 14, 2012 |
| Arrest location: | 1395 OLD VIRGINIA CT |
| Booking date: | Jun 14, 2012 |
| Booking location: | Cobb County, GA |
| Booking location: | Cobb County, GA |
| Warrant date: | May 16, 2012 |
| Warrant: | 11-9-135-48 |
| Type: | FI |
| Section: | 42-8-38 |
| Description: | VIOL. OF PROBATION |
| Counts: | 01/ |
| Code: | OCGA |
| Bond amount: | No bail |
