INC-CON-73

Code
INC-CON-73
Mercy ID
V-01561-01
Encounter Date
03/31/2004
Last
Incapie
First
Concepcion
DOB
03/11/1973
County
Fulton
Street
2104 Hemingway Ln.
City
Roswell
State
GA
Zip
30075-
Home
(678) 464-6538
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Incapie
First
Jorge
DOB
02/17/1960
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
YES
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
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Natzyelee Incapie 06/27/2002 Mother GA/USA
Xarumy Incapie 04/11/1995 Mother GA/USA
NOTES

Media Authoritation

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