| Date of birth: | Dec 31, 1955 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2013-021599 |
| Booking date: | Sep 29, 2013 |
| Booking location: | Polk County, FL |
| Surety: | 250 |
| Statute: | 322.34(2) MOVING TRAFFIC VIOL-KNOWINGLY DRIVE WHILE LIC SUSP |
| Charge on arrest docket: | KDWLSR |
| Charge number: | 1 |
| Cash: | 250 |