| Date of birth: | Jan 22, 1948 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2013-000295 |
| Booking date: | Jan 4, 2013 |
| Release date: | Jan 4, 2013 |
| Booking location: | Polk County, FL |
| Statute: | 901.31 FAILURE TO APPEAR-WRITTEN PROMISE TO APPEAR |
| Charge on arrest docket: | FTA DOCK - ISS/OBT PROP W/CHECK |
| Charge number: | 1 |