| Date of birth: | May 10, 1966 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00019238 |
| Booking date: | May 12, 2004 |
| Release date: | May 16, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.34 - DWLSR |
| Offense date: | May 12, 2004 |
| Bond amount: | $500 |
| Statute: | DEL.9999.999 - VEHICLE NOT INS. |
| Offense date: | May 12, 2004 |
| Bond amount: | $500 |