| Date of birth: | Jul 14, 1964 |
| Hair: | Brown |
| Eyes: | Green |
| Inmate number: | 00019961 |
| Booking number: | 2004004959 |
| Booking date: | Jul 14, 2004 |
| Release date: | Jul 14, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 806.13 - FELONY CM |
| Offense date: | Jul 14, 2004 |
| Bond amount: | $1,500 |