Code
SAL-ALI-77
Mercy ID
V-02274-01
Encounter Date
06/19/2006
Last
Salinas
First
Alicia
DOB
12/31/1977
County
Gwinnett
Street
3384 Chelsa Lane
City
Norcross
State
GA
Zip
30092-
Cell
(678) 334-0690
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Gutierrez
First
Nemorio
DOB
09/07/1968
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
YES
Driver License Date
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
Brayan Gutierrez 04/22/1999 Mother GA/USA
Jose E Gutierrez 05/31/1995 Mother GA/USA
Oscar Gutierrez 09/22/1996 Mother GA/USA
Sheily Gutierrez 03/08/2005 Mother GA/USA
NOTES

Media Authoritation

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