| Date of birth: | Jan 14, 1956 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00017634 |
| Booking date: | Nov 30, 2003 |
| Release date: | Nov 30, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DRIVING UNDER THE INFLUENCE |
| Offense date: | Nov 30, 2003 |
| Bond amount: | $750 |
| Statute: | 316.061 - CRASH - LEAVING SCENE OF ACCIDENT |
| Offense date: | Nov 30, 2003 |
| Bond amount: | $750 |