| Date of birth: | Jun 18, 1938 |
| Hold: | no |
| Booking number: | 2004-010503 |
| Booking date: | May 6, 2004 |
| Release date: | May 28, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 316.193(3C1) TRAFFIC OFFENSE-DUI AND DAMAGE PROPERTY |
| Charge on arrest docket: | DUI W/DAMAGE TO A PERSON |
| Charge number: | 1 |