| Date of birth: | Aug 13, 1963 |
| Hold: | no |
| Booking number: | 1996-014134 |
| Booking date: | Aug 21, 1996 |
| Release date: | Aug 23, 1996 |
| Booking location: | Polk County, FL |
| Statute: | 784.08 ASSAULT/BATTERY ON PERSONS 65 OR OLDER |
| Charge on arrest docket: | BATT DV ON PERSON OVER 65 |
| Charge number: | 1 |
| Statute: | 843.02 RESIST/OBST- OFCR W/O VIOLENCE |
| Charge on arrest docket: | ROWOV |
| Charge number: | 2 |