| Date of birth: | Feb 26, 1966 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2004-022237 |
| Booking date: | Oct 1, 2004 |
| Release date: | Oct 23, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 322.34(2A) NONMOVING TRAFFIC VIOL-DRIVE WHILE LIC SUSP 1ST OF |
| Charge on arrest docket: | DWLSR FTA DISP |
| Charge number: | 1 |