Code
LOZ-MAR-78
Mercy ID
V-02299-01
Encounter Date
07/17/2006
Last
Lozano
First
Martha
DOB
10/16/1978
County
Rockdale
Street
1277 Cliff Arrive
City
Coneyrs
State
GA
Zip
30012-
Cell
(678) 793-6139
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Barriento
First
Claudio
DOB
06/06/1971
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
YES
DFACS County
Rockdale
Alcohol & Drug
No
# of DUIs
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
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
Erick Contreras 02/17/2000 Mother w/Stepfather GA/USA
Fatima Contreras 05/18/1995 Mother w/Stepfather GA/USA
Guadalupe de Jesús Contreras 09/23/1993 DFACS GA/USA

Former Spouse 1 Information

Last
Contreras
First
Rene
DOB
10/12/1976
Telephone
N/A
COB
N/A
Home Owner
No
NOTES
Referida a Atlanta Legal Aid

Media Authoritation

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