| Date of birth: | May 12, 1952 |
| Hair: | Salt/pepper |
| Eyes: | Green |
| Inmate number: | 00021190 |
| Booking number: | 2004007744 |
| Booking date: | Oct 28, 2004 |
| Release date: | Oct 28, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.34 - DWLSR |
| Offense date: | Oct 28, 2004 |
| Bond amount: | $750 |