| Date of birth: | Feb 1, 1952 |
| Hold: | no |
| Booking number: | 1996-014919 |
| Booking date: | Sep 1, 1996 |
| Release date: | Sep 1, 1996 |
| Booking location: | Polk County, FL |
| Statute: | 784.07 ASSAULT/BATTERY ON LAW ENFORCEMENT OFFICER |
| Charge on arrest docket: | BATTERY ON A LEO |
| Charge number: | 1 |
| Bond type: | CBN |
| Bond number: | 00013229 |
| Bond amount: | $250 |