| Date of birth: | Jan 17, 1961 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2004-015527 |
| Booking date: | Jul 6, 2004 |
| Release date: | Aug 9, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 901.36(1) FRAUD-IMPERSON-FALSE ID GIVEN TO LEO |
| Charge on arrest docket: | GIVE FALSE INFO TO LEO REMANDED 072304 |
| Charge number: | 4 |
| Statute: | 948.06 PROB VIOLATION-OR COMMTY CONT RE UNK/FEL/MISD/JUV |
| Charge on arrest docket: | VOP/OBT PROP W-CHECK |
| Charge number: | 1 |
| Statute: | 948.06 PROB VIOLATION-OR COMMTY CONT RE UNK/FEL/MISD/JUV |
| Charge on arrest docket: | VOP/OBT PROP W-CHECK |
| Charge number: | 2 |
| Statute: | 948.06 PROB VIOLATION-OR COMMTY CONT RE UNK/FEL/MISD/JUV |
| Charge on arrest docket: | VOP/OBT PROP W-CHECK |
| Charge number: | 3 |
