| Date of birth: | Aug 31, 1961 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00019274 |
| Booking number: | 2004003427 |
| Booking date: | May 14, 2004 |
| Release date: | May 23, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DUI REFUSAL |
| Offense date: | May 14, 2004 |
| Bond amount: | $750 |