| Date of birth: | Nov 16, 1949 |
| Hold: | no |
| Booking number: | 1996-015062 |
| Booking date: | Sep 4, 1996 |
| Release date: | Oct 3, 1996 |
| Booking location: | Polk County, FL |
| Statute: | 812.014(2D) PETIT THEFT - OTHER........ |
| Charge on arrest docket: | P/R THEFT INFO FILED |
| Charge number: | 1 |
| Statute: | 812.014(2D) PETIT THEFT - OTHER........ |
| Charge on arrest docket: | P/R THEFT INFO FILED |
| Charge number: | 4 |
| Statute: | 831.01 FORGERY |
| Charge on arrest docket: | FORGERY INFO FILED |
| Charge number: | 2 |
| Statute: | 831.02 UTTER FORGED INSTRUMENT |
| Charge on arrest docket: | UTTER FORG INST INFO FILED |
| Charge number: | 3 |
