| Date of birth: | Sep 10, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00019441 |
| Booking number: | 2004003833 |
| Booking date: | May 29, 2004 |
| Release date: | May 30, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 327.35 - BUI |
| Offense date: | May 29, 2004 |
| Bond amount: | $500 |