| Date of birth: | Mar 11, 1941 |
| Hold: | no |
| Booking number: | 1996-011714 |
| Booking date: | Jul 11, 1996 |
| Release date: | Jul 30, 1996 |
| Booking location: | Polk County, FL |
| Statute: | 812.014(2D) PETIT THEFT - OTHER........ |
| Charge on arrest docket: | P/T FTA ARRG |
| Charge number: | 1 |