| Date of birth: | Jul 27, 1934 |
| Hold: | no |
| Booking number: | 1993-017394 |
| Booking date: | Dec 31, 1993 |
| Release date: | Dec 31, 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: | IK-35435 |