| Date of birth: | Feb 10, 1961 |
| Hair: | Gray |
| Eyes: | Blue |
| Number: | 00021348 |
| Booking date: | Nov 12, 2004 |
| Release date: | Nov 12, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DUI |
| Offense date: | Nov 12, 2004 |
| Bond amount: | $1,500 |
| Statute: | 316.193 - REFUSAL TO SUBMIT TEST/DUI |
| Offense date: | Nov 12, 2004 |
| Bond amount: | $1,500 |