PAV-VIC-81

Code
PAV-VIC-81
Mercy ID
V-00496-02
Encounter Date
05/01/2001
Last
Pavon
First
Victor
DOB
01/09/1981
County
Gwinnett
Street
677 Sunfield Dr. NW
City
Lilburn
State
GA
Zip
30047-
Home
(770) 279-2720
Cell
(678) 428-0693
Family Status
Adult coupie-no children
COB
Honduras
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Farias
First
Miosotis
DOB
N/A
Address
N/A
Telephone
N/A
COB
Dominican Rep
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Former Spouse 1 Information

Last
Diaz
First
Maricela
DOB
N/A
Telephone
N/A
COB
N/A
Home Owner
No
NOTES
Miosotis, Farias ID is V-01846-01. Pavon, Victor kept the ID of the former partner Diaz, Maricela

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
K. Aleman
Referred By