MAY-ADE-73

Code
MAY-ADE-73
Mercy ID
V-01424-01
Encounter Date
11/24/2003
Last
Maya
First
Adela
DOB
06/17/1973
County
Dekalb
Street
3353 B Peachtree Corner Cr.
City
Norcross
State
GA
Zip
30092-
Cell
(770) 895-5016
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Martinez
First
Hermelindo
DOB
10/28/1980
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Allen Ivan Alvarez 07/03/2001 Mother w/Stepfather GA/USA
Cindy Alvarez 05/21/1997 Mother w/Stepfather GA/USA
Jesus E. Maya 05/16/2008 Mother w/Stepfather GA/USA
Maria Alvarez 11/13/1992 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Alvarez
First
Simeon
DOB
09/15/1970
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
YES
Intake
J. Perez
Data Entry
K. Aleman
Referred By
x3737 Damaryz