| Date of birth: | Apr 6, 1927 |
| Hold: | no |
| Booking number: | 1993-015562 |
| Booking date: | Nov 16, 1993 |
| Release date: | Nov 17, 1993 |
| Booking location: | Polk County, FL |
| Statute: | 790.01 CONCEALED WEAPON |
| Charge on arrest docket: | CARRYING CONCEALED FIREARM |
| Charge number: | 1 |