| Date of birth: | Jul 14, 1950 |
| Hold: | no |
| Booking number: | 1996-016748 |
| Booking date: | Oct 2, 1996 |
| Release date: | Oct 2, 1996 |
| Booking location: | Polk County, FL |
| Statute: | 784.045 AGG BATTERY |
| Charge on arrest docket: | AGG BATTERY DOMESTIC VIOLENCE |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | XD-69398 |
| Bond amount: | $1,000 |