| Date of birth: | Nov 19, 1959 |
| Hair: | Black |
| Eyes: | Brown |
| Number: | 00019863 |
| Booking date: | Jul 5, 2004 |
| Release date: | Aug 3, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - CHILD SUPPORT ENFORCEMENT ORDER INCLUDING CIVIL CONTEMPT ORDER |
| Offense date: | Jul 5, 2004 |
| Case number: | 00-3024-FD |