| Date of birth: | Jan 7, 1944 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2004-002529 |
| Booking date: | Feb 2, 2004 |
| Release date: | Feb 3, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 316.193(2A) TRAFFIC OFFENSE-DUI ALCOHOL OR DRUGS 1ST OFF |
| Charge on arrest docket: | DUI (REFUSED) |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | AS5361920 |
| Bond exp: | SBN AS5-361920 FOR $500.00 |
| Bond amount: | $500 |