| Date of birth: | Jul 4, 1954 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2012-027946 |
| Booking date: | Nov 5, 2012 |
| Booking location: | Polk County, FL |
| Statute: | 784.041(1) BATTERY-COMMIT FELONY BATTERY |
| Charge on arrest docket: | FELONY BATTERY |
| Charge number: | 1 |