| Date of birth: | Nov 27, 1945 |
| Hold: | no |
| Arresting agency: | BARTOW POLICE DEPT. |
| Booking number: | 1997-016860 |
| Booking date: | Sep 4, 1997 |
| Release date: | Sep 5, 1997 |
| Booking location: | Polk County, FL |
| Statute: | 784.03 BATTERY-NON SERIOUS INJURY |
| Charge on arrest docket: | BATTERY DV FTA ORD REV PTR |
| Charge number: | 1 |