| Date of birth: | Apr 6, 1973 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00014749 |
| Booking date: | Jan 12, 2004 |
| Release date: | Jan 15, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 941.02 - FFJ (WEST VIRGINIA) |
| Offense date: | Jan 12, 2004 |
| Bond amount: | $100,000 |
| Statute: | DEL.9999.999 - HOLD/WEST VIRGINIA |
| Offense date: | Jan 12, 2004 |
| Bond amount: | $100,000 |