| Bond amount: | $1,000 |
| Arresting agency: | SMP |
| Arrest officer: | VERHAAR |
| Booking number: | 2012100093 |
| Booking date: | Oct 13, 2012 |
| Release date: | Oct 13, 2012 |
| Jail name: | Polk County Jail |
| Location: | 884 SE Jefferson St, Dallas, OR 97338 |
| Statute: | 137.05 |
| Description: | BW/FTA (11-40892B) |
| Bond amount: | $1,000 |