| Date of birth: | Aug 4, 1960 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 11016175 |
| Active: | N |
| Booking number: | B15029427 |
| Booking date: | Nov 4, 2015 |
| Release date: | Nov 5, 2015 |
| Booking location: | Walton County, FL |
| Violation level: | F |
| Violation description: | FRAUD EMP NOT GET WORK COMP INS UNDER 20K DOLS |
| Violation code: | 440.105(4A3) |
| Required cash amount: | $2,500 |
| Obts number: | 6601050325 |
| Clear type: | CASH/SURETY |
| Charge number: | 1 |
| Bond type: | CASH/SURETY |
| Bond number: | W075987 |
| Bond amount: | $2,500 |
| Arrest location: | 119 TWIN LAKES DR |
| Arrest date: | Nov 4, 2015 |
| Agency case number: | 15-1744 |
