| Date of birth: | Mar 29, 1950 |
| Hair: | White |
| Eyes: | Blue |
| Number: | 00017643 |
| Booking date: | Dec 2, 2003 |
| Release date: | Dec 2, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DUI W/PROP DAMAGE AND PERS INJURY |
| Offense date: | Dec 2, 2003 |
| Bond amount: | $500 |