SAL-CRE-52

Code
SAL-CRE-52
Mercy ID
V-02310-01
Encounter Date
08/01/2006
Last
Salles geib
First
Creuza
DOB
12/02/1952
County
Other
Street
42 Iron Weend
City
Pueblo
State
GA
Zip
81001-
Home
(719) 543-0330
Family Status
Two parent family w/children
COB
Brazil
Gender
Female
Housing
Not Homeless

Spouse Information

Last
Geib
First
Heribert
DOB
12/08/1946
Address
N/A
Telephone
N/A
COB
Brazil
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
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
Federico Geib 08/19/1984 Adulto/Casado GA/USA
Johann Geib 11/06/1987 Parents GA/USA
Peter Geib 08/22/1983 Adulto/Soltero 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
J. Manzo
Referred By