| Date of birth: | Sep 24, 1954 |
| Hold: | no |
| Arresting agency: | WINTER HAVEN POLICE DEPT. |
| Booking number: | 2004-018102 |
| Booking date: | Aug 7, 2004 |
| Release date: | Aug 8, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 784.03(1A1) BATTERY-TOUCH OR STRIKE |
| Charge on arrest docket: | DOMESTIC VIOL (SIMPLE BATTERY) |
| Charge number: | 1 |