| Date of birth: | Oct 21, 1952 |
| Hold: | no |
| Booking number: | 1996-006990 |
| Booking date: | Apr 23, 1996 |
| Release date: | May 22, 1996 |
| Booking location: | Polk County, FL |
| Statute: | 784.021 AGG ASSAULT |
| Charge on arrest docket: | AGG ASSAULT W/DEADLY WEAPON DV |
| Charge number: | 1 |