| Date of birth: | Aug 11, 1947 |
| Hold for: | ARIZONA |
| Hold: | yes |
| Disposition of hold: | TRANS TO ARIZONA |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2004-013736 |
| Booking date: | Jun 15, 2004 |
| Release date: | Aug 14, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 941.13 OUT-OF-STATE-FUG-REF-FUGITIVE WARRANT OF EXTRADITI |
| Charge on arrest docket: | FUG FROM JUSTICE ARIZONA |
| Charge number: | 1 |