| Date of birth: | Jan 25, 1965 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00040779 |
| Booking date: | Nov 12, 2009 |
| Release date: | Nov 12, 2009 |
| Booking location: | Okaloosa County, FL |
| Statute: | 901.04 - OUT-OF-COUNTY WARRANT |
| Offense date: | Nov 12, 2009 |
| Bond amount: | $2,000 |
| Arrest date: | Nov 12, 2009 |