| Date of birth: | Jul 18, 1960 |
| Hold: | no |
| Booking number: | 1993-013680 |
| Booking date: | Oct 9, 1993 |
| Release date: | Oct 9, 1993 |
| Booking location: | Polk County, FL |
| Surety: | 5000 |
| Statute: | 784.03 BATTERY-NON SERIOUS INJURY |
| Charge on arrest docket: | BATT/DV |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | IC-802510 |