| Date of birth: | Nov 4, 1966 |
| Jacket number: | 0439859 |
| Holds for other agencies: | No |
| Arresting agency: | 01-PBSO |
| Booking number: | 2012048921 |
| Booking date: | Nov 21, 2012 |
| Booking location: | Palm Beach County, FL |
| Description: | FRAUD-IMPERSON - FALSE ID GIVEN TO LEO |
| Charge number: | 901.36-3978 |
| Bond amount: | $0 |