ACE-CLA-80

Code
ACE-CLA-80
Mercy ID
V-02360-01
Encounter Date
11/27/2006
Last
Acevedo
First
Claudia
DOB
01/31/1980
County
Fulton
Street
3401 S. Highway 81 Lot-3 Oxford
City
Atlanta
State
GA
Zip
30054-
Home
(678) 625-7932
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Gonzalez
First
Esteban
DOB
09/09/1979
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Diana Gonzalez 06/11/2001 Grandmother Mexico
Estefania M. Gonzalez 05/28/1999 Grandmother Mexico
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