| Date of birth: | Nov 6, 1948 |
| Hair: | Brown |
| Eyes: | Hazel |
| SO#: | 29133 |
| Arresting agency: | Brazoria County Sheriff's Office |
| Booking number: | 71865 |
| Booking date: | Sep 22, 2004 |
| Release date: | Sep 23, 2004 |
| Booking location: | Brazoria County, TX |
| Warrant: | HJ005204 |
| Issuing authority: | 4-2 |
| Fine or court cost: | $300 |
| Charge: | PUBLIC INTOXICATION |