| Date of birth: | 1980 |
| Hair: | White |
| Eyes: | Brown |
| Registration: | 25113 |
| Level: | Level One |
| Comments: | SEXUAL CONTACT, YES DEVIATE SEXUAL INTERCOURSE, YES NON-STRANGER |
| Description: | Tattoo on () |
| Arresting agency: | St. Lawrence County Sheriff's Office |
| Booking location: | St. Lawrence County, NY |