| Date of birth: | Dec 18, 1954 |
| Hair: | Brown |
| Eyes: | Hazel |
| Number: | 00018429 |
| Booking date: | Feb 22, 2004 |
| Release date: | Feb 24, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DRIVING UNDER THE INFLUENCE (REFUSED) |
| Offense date: | Feb 22, 2004 |
| Bond amount: | $5,000 |