| Date of birth: | Sep 19, 1964 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00021423 |
| Booking number: | 2004008296 |
| Booking date: | Nov 19, 2004 |
| Release date: | Nov 24, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - BAY CO.VOP/ POCS |
| Offense date: | Nov 19, 2004 |