| Date of birth: | Apr 5, 1935 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2013-007762 |
| Booking date: | Apr 5, 2013 |
| Release date: | Apr 5, 2013 |
| Booking location: | Polk County, FL |
| Statute: | 901.31 FAILURE TO APPEAR-WRITTEN PROMISE TO APPEAR |
| Charge on arrest docket: | CRIMINAL MISCHIEF TO WIT FTA ARRG |
| Charge number: | 1 |