| Date of birth: | Jul 15, 1966 |
| Hold: | no |
| Booking number: | 1993-017171 |
| Booking date: | Dec 23, 1993 |
| Release date: | Dec 25, 1993 |
| Booking location: | Polk County, FL |
| Statute: | 322.212(5) FALSE NAME/AGE ON DL - FALSE APPLIC |
| Charge on arrest docket: | OBT LIC BY FRAUD |
| Charge number: | 1 |
| Cash: | 250 |
| Bond type: | CBN |
| Bond number: | 1870106A |