| Date of birth: | Feb 16, 1956 |
| Hair: | Blond/strawberry |
| Eyes: | Gray |
| Number: | 00021991 |
| Booking date: | Jan 10, 2005 |
| Release date: | Jan 10, 2005 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.13 - POM |
| Offense date: | Jan 10, 2005 |
| Bond amount: | $1,000 |
| Statute: | 320.261 - ATTACHING TAG NOT ASSIGNED |
| Offense date: | Jan 10, 2005 |
| Bond amount: | $1,000 |