| Date of birth: | Sep 30, 1963 |
| Hold: | no |
| Arresting agency: | AUBURNDALE POLICE DEPT. |
| Booking number: | 2004-014131 |
| Booking date: | Jun 19, 2004 |
| Release date: | Jul 16, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 784.045(1A1) AGGRAV BATTERY-CAUSE BODILY HARM OR DISABILITY |
| Charge on arrest docket: | BATTERY/AGG |
| Charge number: | 1 |