| Date of birth: | Apr 5, 1961 |
| Hair: | Brown |
| Eyes: | Blue |
| Inmate number: | 00019618 |
| Booking number: | 2004004232 |
| Booking date: | Jun 14, 2004 |
| Release date: | Jun 15, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 784.03 - BATTERY/ DOMV |
| Offense date: | Jun 14, 2004 |