| Hair: | Black |
| Eyes: | Brown |
| SO#: | 120843 |
| Arresting agency: | Lewisville Police Department |
| Booking number: | 344557 |
| Booking date: | Nov 23, 2004 |
| Release date: | Nov 23, 2004 |
| Booking location: | Denton County, TX |
| Warrant: | K019097601 |
| Offense date: | Nov 23, 2004 |
| Issuing authority: | PD GRAND PRAIRIE |
| Fine or court cost: | $490 |
| Charge: | ASSLT CBI FV |
| Bond type: | $490 Cash Bond |