| Date of birth: | Oct 17, 1941 |
| Hold: | no |
| Booking number: | 2004-006227 |
| Booking date: | Mar 15, 2004 |
| Release date: | May 27, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 322.34(2A) NONMOVING TRAFFIC VIOL-DRIVE WHILE LIC SUSP 1ST OF |
| Charge on arrest docket: | KNOWINGLY DWLSR |
| Charge number: | 1 |