| Date of birth: | Sep 22, 1949 |
| Hair: | Gray |
| Eyes: | Hazel |
| Number: | 00007167 |
| Booking date: | Sep 15, 2004 |
| Release date: | Sep 17, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.34 - DRIVING WHILE LICENSE SUSPENDED OR REVOKED(HABITUAL TRAFFIC VIOLATOR) |
| Offense date: | Sep 15, 2004 |