| Date of birth: | Nov 29, 1962 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00019254 |
| Booking date: | May 13, 2004 |
| Release date: | May 16, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 941.02 - FFJ/MISSOURI-DUI |
| Offense date: | May 13, 2004 |
| Bond amount: | $250 |
| Statute: | 893.13 - POM |
| Offense date: | May 13, 2004 |
| Bond amount: | $250 |