| Date of birth: | Nov 13, 1963 |
| Hold: | no |
| Dna: | yes |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2015-001019 |
| Booking date: | Jan 14, 2015 |
| Release date: | Jan 16, 2015 |
| Booking location: | Polk County, FL |
| Statute: | 784.045(1A1) AGGRAV BATTERY-CAUSE BODILY HARM OR DISABILITY |
| Charge on arrest docket: | DV-BATT BODIL HARM/DISAB |
| Charge number: | 1 |