| Date of birth: | Nov 26, 1942 |
| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 85645 |
| Arresting agency: | Brookside Village Police Department |
| Booking number: | 68490 |
| Booking date: | Jun 29, 2004 |
| Release date: | Jun 30, 2004 |
| Booking location: | Brazoria County, TX |
| Warrant: | FJS2066 |
| Issuing authority: | 3-2 |
| Fine or court cost: | $400 |
| Charge: | PUBLIC INTOXICATION C |