| Date of birth: | Mar 29, 1960 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2012-026678 |
| Booking date: | Oct 20, 2012 |
| Release date: | Oct 22, 2012 |
| Booking location: | Polk County, FL |
| Statute: | 784.041(1) BATTERY-COMMIT FELONY BATTERY |
| Charge on arrest docket: | FEL BATTERY RESULT BODILY HARM DV |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | AA12017678 |
| Bond exp: | PTR/SBN#AA12-017678 $5000 |
| Bond amount: | $5,000 |