| Date of birth: | May 9, 1949 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2011-014695 |
| Booking date: | Jun 23, 2011 |
| Release date: | Jun 23, 2011 |
| Booking location: | Polk County, FL |
| Statute: | 784.03(1A1) BATTERY-TOUCH OR STRIKE |
| Charge on arrest docket: | BATTERY DV |
| Charge number: | 1 |
| Statute: | 784.07(2C) ASSAULT-ON OFFICER FIREFIGHTER EMT ETC |
| Charge on arrest docket: | ASSLT ON OFFICER |
| Charge number: | 2 |