| Date of birth: | May 24, 1924 |
| Hold: | no |
| Booking number: | 1995-017750 |
| Booking date: | Oct 31, 1995 |
| Release date: | Oct 31, 1995 |
| Booking location: | Polk County, FL |
| Statute: | 784.021 AGG ASSAULT |
| Charge on arrest docket: | AGG ASSAULT |
| Charge number: | 1 |
| Bond type: | CBN |
| Bond number: | 00010768 |
| Bond amount: | $250 |