| Date of birth: | Nov 9, 1966 |
| Hair: | Brown-gray |
| Eyes: | Brown |
| Unit description: | 941 Mallard Lane, #105, Balsam Lake, WI 54810, (715)485-3114 |
| Unit: | 5 08 |
| Pin number: | 948015 |
| Photo date: | Mar 18, 2013 |
| Inmate status: | ACTIVE COMMUNITY SUPERVISION |
| Booking number: | 00599575 |
| Booking location: | Polk County, WI |
| Statute: | 961.41(1)(H)1 F, 961.41(1X) |
| County: | POLK |
| Convicted: | Mar 5, 2013 |
| Case number: | 12CF118 |