| Date of birth: | 1950 |
| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 000031393 |
| Releasing officer: | 002754 |
| Duration of custody: | 8 |
| Comments: | A/T: INGRAM W/G: JACKSONBRADLEY OTN:112963561 |
| Birth place: | GA |
| Type: | OT |
| Side: | L |
| Description: | SURGICAL SCARS |
| Body part: | A |
| Type: | OT |
| Side: | L |
| Description: | SURGICAL |
| Body part: | M |
| Arresting agency: | GA0330300 |
| Arrest number: | 000401425 |
| Arrest date: | Jul 4, 2003 |
| Arrest location: | 2108 AUGUSTA DR |
| Booking date: | Jul 4, 2003 |
| Booking location: | Cobb County, GA |
| Warrant date: | Jul 4, 2003 |
| Warrant: | 03-W-7127 |
| Type: | MU |
| Section: | 16-5-23.1 |
| Offense date: | Jul 4, 2003 |
| Description: | BATTERY |
| Counts: | 01/ |
| Code: | OCGA |
| Bond amount: | $1,000 |
