| Date of birth: | Jan 27, 1942 |
| Hold: | no |
| Arresting agency: | FORT MEADE POLICE DEPT. |
| Booking number: | 2004-017136 |
| Booking date: | Jul 26, 2004 |
| Release date: | Jul 27, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 322.34(2A) NONMOVING TRAFFIC VIOL-DRIVE WHILE LIC SUSP 1ST OF |
| Charge on arrest docket: | DWLSR W/KNOWLEDGE |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | AA04381679 |
| Bond exp: | SBN AA04381679 $250 |
| Bond amount: | $250 |