CRU-MAN-74

Code
CRU-MAN-74
Mercy ID
V-03093-02
Encounter Date
06/02/2009
Last
Cruz
First
Manuel
DOB
07/16/1974
County
Fulton
Street
1198 Stoneybrook Road
City
Forest park
State
GA
Zip
30297-
Cell
(404) 441-6974
Family Status
Single adult
COB
Mexico
Gender
Male
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
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
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
Aldo Cruz 11/08/2007 Mother GA/USA
Estephanie Cruz 06/05/2005 Mother GA/USA
Manuel Cruz 08/08/2002 Mother GA/USA

Former Spouse 1 Information

Last
Pelcastre
First
Agustina
DOB
05/28/1968
Telephone
(678) 683-2182
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 Cty court