| Date of birth: | Jun 11, 1955 |
| Booking number: | 2016-021738 |
| Booking date: | Jun 5, 2016 |
| Booking location: | Polk County, FL |
| Surety: | 5000.00 |
| Statute: | 784.045(1)(A)2...* Dom Viol-Agg Battery Deadly Weapon |
| Charge on arrest docket: | >DV AGG BATTERY DEADLY WEAPON |
| Bond type: | CS |