| Date of birth: | Jul 7, 1960 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2004-014529 |
| Booking date: | Jun 24, 2004 |
| Release date: | Jun 25, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 784.03(1A1) BATTERY-TOUCH OR STRIKE |
| Charge on arrest docket: | BATTERY (DOMESTIC VIOLENCE) |
| Charge number: | 1 |
| Statute: | 784.011 ASSLT-INTENT THREAT TO DO VIOLENCE |
| Charge on arrest docket: | ASSAULT (DOMESTIC VIOLENCE) |
| Charge number: | 2 |
