| Date of birth: | Jun 30, 1968 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00019376 |
| Booking number: | 2004003685 |
| Booking date: | May 24, 2004 |
| Release date: | May 24, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/DWLSR |
| Offense date: | May 24, 2004 |
| Case number: | 03-2954 |
| Bond amount: | $300 |