ITU-IVA-76

Code
ITU-IVA-76
Mercy ID
V-00084-02
Encounter Date
12/20/2005
Last
Iturbe
First
Ivan
DOB
05/06/1976
County
Gwinnett
Street
5917 Marydoln
City
Norcross
State
GA
Zip
30093-
Home
(678) 615-2279
Cell
(404) 449-0651
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Other
Education Level
High school graduate

Spouse Information

Last
Soriano
First
Nancy
DOB
03/03/1978
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
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
Andrea Iturbe 03/26/2002 Parents GA/USA
Enrique Iturbe 09/02/2000 Parents GA/USA
Fernanda Iturbe 07/07/1996 Parents GA/USA
Mariana Iturbe 03/21/1995 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
R. Gonzalez
Referred By
DFCS