| Date of birth: | May 18, 1958 |
| Hair: | Brown |
| Eyes: | Blue |
| Number: | 00021071 |
| Booking date: | Oct 18, 2004 |
| Release date: | Nov 22, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.34 - DWLSR |
| Offense date: | Oct 18, 2004 |
| Case number: | 04CT3280S |
| Statute: | 948.06 - VOP/DUI,POM(SANTA ROSA COUNTY) |
| Offense date: | Oct 18, 2004 |
| Statute: | DEL.9999.999 - HOLD/SANTA ROSA COUNTY |
| Offense date: | Oct 18, 2004 |