| Date of birth: | Dec 3, 1928 |
| Hair: | Gray |
| Eyes: | Hazel |
| Inmate number: | 00021249 |
| Booking number: | 2005000200 |
| Booking date: | Jan 6, 2005 |
| Release date: | Jan 6, 2005 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DUI |
| Offense date: | Jan 6, 2005 |
| Case number: | 04-5372-OF |
| Bond amount: | $2,500 |