| Date of birth: | Mar 4, 1920 |
| Hair: | White |
| Eyes: | Green |
| Number: | 00020100 |
| Booking date: | Jul 25, 2004 |
| Release date: | Jul 25, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DRIVING UNDER THE INFLUENCE |
| Offense date: | Jul 25, 2004 |
| Bond amount: | $500 |