CRU-ZLI-81

Code
CRU-ZLI-81
Mercy ID
V-02951-01
Encounter Date
11/25/2008
Last
Cruz
First
Liliana
DOB
12/15/1982
County
Forsyth
Street
2020 Pilgrim Road # 103
City
Cumming
State
GA
Zip
30040-
Cell
(678) 851-2427
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
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
Cristian Cruz 04/15/2000 Mother GA/USA
Iraiz Cruz 01/14/2003 Mother GA/USA
Marco A. Hernandez 08/28/2006 Mother GA/USA

Former Spouse 1 Information

Last
Hernandez
First
Victor
DOB
01/13/1984
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
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Griselda