| Date of birth: | Jun 5, 1928 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 1998-017196 |
| Booking date: | Aug 31, 1998 |
| Release date: | Sep 1, 1998 |
| Booking location: | Polk County, FL |
| Statute: | 784.011 ASSAULT-SERIOUS INJURY |
| Charge on arrest docket: | ASSLT D/V |
| Charge number: | 1 |