| Date of birth: | 1971 |
| Eyes: | Blue |
| Facility: | Stearns |
| Arrest date: | Dec 12, 2012 |
| Booking date: | Dec 12, 2012 |
| Booking location: | Stearns County, MN |
| Weekender: | No |
| Statute number: | 169A-20 2 169A-25 |
| Court docket number: | K4-04-1136 |
| Controlling agency: | STEARNS SERVING |
| Charge level: | Felony |
| Charge: | REFUSAL TO TEST |