| Date of birth: | Sep 22, 1935 |
| Hold: | no |
| Booking number: | 1997-005218 |
| Booking date: | Mar 17, 1997 |
| Release date: | Mar 19, 1997 |
| Booking location: | Polk County, FL |
| Statute: | 784.03 BATTERY-NON SERIOUS INJURY |
| Charge on arrest docket: | BATT DV |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | BB602047 |
| Bond amount: | $5,000 |