| Date of birth: | Aug 28, 1966 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00019171 |
| Booking number: | 2004003182 |
| Booking date: | May 6, 2004 |
| Release date: | May 6, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 320.261 - ATT TAG |
| Offense date: | May 6, 2004 |
| Bond amount: | $250 |
| Statute: | 322.34 - DWLSR |
| Offense date: | May 6, 2004 |
| Bond amount: | $250 |