| Date of birth: | Jun 10, 1983 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00019982 |
| Booking date: | Jul 16, 2004 |
| Release date: | Jul 16, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.13.1 - POCS(MARI) |
| Offense date: | Jul 16, 2004 |
| Bond amount: | $3,500 |
| Statute: | 893.147 - POP |
| Offense date: | Jul 16, 2004 |
| Bond amount: | $3,500 |