IBA-ILI-75

Code
IBA-ILI-75
Mercy ID
V-02975-01
Encounter Date
12/22/2008
Last
Ibarra
First
Ilia
DOB
09/30/1975
County
Gwinnett
Street
1109 hampton Ridge Road
City
Norcross
State
GA
Zip
30093-
Cell
(404) 964-4057
Family Status
Two parent family w/children
COB
Guatemala
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
Katherine L. Martinez 06/28/2001 Father GA/USA

Former Spouse 1 Information

Last
Martinez
First
Jorge
DOB
02/21/1977
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. Perez
Data Entry
J. Manzo
Referred By
ligia Aguilar-clienta/cell Juana