| Bond amount: | $10,000 |
| Arresting agency: | DAP |
| Arrest officer: | COLLINGHAM |
| Booking number: | 2004010120 |
| Booking date: | Jan 15, 2004 |
| Release date: | Jan 15, 2004 |
| Jail name: | Polk County Jail |
| Location: | 884 SE Jefferson St, Dallas, OR 97338 |
| Statute: | 475.992 |
| Description: | PCS II |
| Bond amount: | $10,000 |