| Date of birth: | Sep 2, 1954 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2012-027523 |
| Booking date: | Oct 31, 2012 |
| Booking location: | Polk County, FL |
| Surety: | 2000 |
| Statute: | 901.31 FAILURE TO APPEAR-WRITTEN PROMISE TO APPEAR |
| Charge on arrest docket: | K/DWLSR FTA DOCK |
| Charge number: | 1 |
| Cash: | 2000 |