| Date of birth: | Feb 10, 1968 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00001965 |
| Booking number: | 2004006201 |
| Booking date: | Sep 1, 2004 |
| Release date: | Sep 5, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 843.15 - FTA/WC |
| Offense date: | Sep 1, 2004 |
| Case number: | 04MM6749S |
| Bond amount: | $200 |
