ACO-FRA-60

Code
ACO-FRA-60
Mercy ID
V-01599-02
Encounter Date
05/18/2004
Last
Acosta
First
Francisco
DOB
10/10/1960
County
Dekalb
Street
3408 Orchard St.
City
Hapeville
State
GA
Zip
30354-
Home
(404) 209-7146
Family Status
Two parent family w/children
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Jimenez
First
Carmen
DOB
08/27/1961
Address
N/A
Telephone
N/A
COB
Dominican Rep
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Katty Acosta 10/31/1989 Parents GA/USA
Kevin Acosta 10/11/1994 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By
Fulton