| Date of birth: | Sep 30, 1947 |
| Hold: | no |
| Arresting agency: | LAKELAND POLICE DEPT. |
| Booking number: | 2004-023133 |
| Booking date: | Oct 12, 2004 |
| Release date: | Oct 15, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 784.03(1A1) BATTERY-TOUCH OR STRIKE |
| Charge on arrest docket: | SIMPLE BATTERY (DOMESTIC) |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | AB04020152 |
| Bond exp: | SBN AB04-020152 FOR 15000.00 |
| Bond amount: | $15,000 |
