| Date of birth: | Jul 19, 1961 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2004-026512 |
| Booking date: | Nov 21, 2004 |
| Release date: | Nov 22, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 877.03 DISORD CONDUCT |
| Charge on arrest docket: | DISORDERLY CONDUCT |
| Charge number: | 1 |
| Bond type: | CBN |
| Bond number: | 04-002401 |
| Bond exp: | CBN 04-002401 FOR 250.00 |
| Bond amount: | $250 |