| Date of birth: | Oct 5, 1971 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00021144 |
| Booking date: | Oct 24, 2004 |
| Release date: | Oct 24, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 489.127.1A - FALSE IMPERSONATION/CONTRACTOR(LEON COUNTY) |
| Offense date: | Oct 24, 2004 |
| Bond amount: | $1,500 |
| Statute: | DEL.9999.999 - HOLD FOR LEON COUNTY |
| Offense date: | Oct 24, 2004 |