| Date of birth: | Sep 11, 1954 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2012-028505 |
| Booking date: | Nov 11, 2012 |
| Release date: | Nov 12, 2012 |
| Booking location: | Polk County, FL |
| Statute: | 784.03(1A1) BATTERY-TOUCH OR STRIKE |
| Charge on arrest docket: | DOMESTIC VIOLENCE-BATTERY TOUCH OR STRIK |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | 2012AA1054 |
| Bond exp: | SBN#2012AA105416 FOR 5000.00 |
| Bond amount: | $5,000 |