| Date of birth: | May 19, 1984 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00019638 |
| Booking number: | 2004004284 |
| Booking date: | Jun 16, 2004 |
| Release date: | Jun 18, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/ POM |
| Offense date: | Jun 16, 2004 |
| Case number: | 04MM620S |
| Bond amount: | $550 |