PIA-VIC-65

Code
PIA-VIC-65
Mercy ID
V-03163-02
Encounter Date
09/22/2009
Last
Pia
First
Victoriano
DOB
11/17/1965
County
Dekalb
Street
17 Clairview Dr.
City
Chamblee
State
GA
Zip
30341-
Cell
(678) 592-8010
Family Status
Two parent family w/children
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Lemus
First
Maria teresa
DOB
08/28/1962
Address
N/A
Telephone
N/A
COB
Guatemala
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
YES
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
Brandon Donovan Pia 08/07/2005 Parents GA/USA
Christian Steven Pia 09/18/2000 Parents GA/USA
Lizzi Maria Pia 12/03/1996 Parents GA/USA
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
Linea-Juana/DFCS-Ana Cordeiro