| Date of birth: | Mar 8, 1945 |
| Report: | 2004-16875/1 |
| Arrest date: | Aug 7, 2004 |
| Arrest location: | CORTEZ BV & LOCKHART RD |
| Booking location: | Hernando County, FL |
| Description: | 316.193 - DRIVING UNDER THE INFLUENCE |
| Description: | 316.1939 - REFUSAL SUBMIT CHEM TEST-INTOX |