| Date of birth: | Mar 9, 1957 |
| Hair: | Brown |
| Eyes: | Green |
| Number: | 00018358 |
| Booking date: | Feb 15, 2004 |
| Release date: | Feb 15, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DRIVING UNDER THE INFLUENCE (REFUSED) |
| Offense date: | Feb 15, 2004 |
| Bond amount: | $500 |