| Date of birth: | Dec 19, 1966 |
| Booking number: | 2015-027427 |
| Booking date: | Oct 9, 2015 |
| Booking location: | Polk County, FL |
| Surety: | 250.00 |
| Statute: | 316.061 Leave Scene of Crash Involve Prop Damage |
| Charge on arrest docket: | >LEAVE SCENE OF CRASH W/PROP DMG |
| Bond type: | CS |