| Date of birth: | Feb 13, 1941 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2000-002543 |
| Booking date: | Feb 4, 2000 |
| Release date: | Feb 5, 2000 |
| Booking location: | Polk County, FL |
| Statute: | 784.03 BATTERY-SERIOUS INJURY |
| Charge on arrest docket: | BATTERY DV |
| Charge number: | 1 |