IBA-KAR-78

Code
IBA-KAR-78
Mercy ID
V-03135-01
Encounter Date
08/03/2009
Last
Ibarra
First
Karla
DOB
10/24/1978
County
Gwinnett
Street
1371 Indian Way
City
Lilburn
State
GA
Zip
30047-
Cell
(678) 558-4414
Other
(404) 707-4945
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Perez
First
Luis
DOB
05/04/1980
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Melissa Perez 08/16/1999 Parents GA/USA
Vanessa Perez 05/11/2006 Parents GA/USA
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
Jackie-El hombre llamo al programa