PAL-LUI-76

Code
PAL-LUI-76
Mercy ID
V-02343-02
Encounter Date
10/24/2006
Last
Palacio
First
Luis
DOB
08/29/1976
County
Fulton
Street
11302 Magnolia Pointe Blvd.
City
Duluth
State
GA
Zip
30096-
Cell
(678) 457-2883
Family Status
Single adult
COB
Colombia
Gender
Male
Housing
Doubling Up
Education Level
Post Grad Degree

Spouse Information

Last
Whitlow
First
Ana patricia
DOB
09/11/1983
Address
N/A
Telephone
(678) 754-0469
COB
Guatemala
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
Paolo Palacio 12/28/2004 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Whitlow
First
Ana patricia
DOB
09/11/1983
Telephone
N/A
COB
N/A
Home Owner
No
NOTES

Media Authoritation

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