PER-JOS-85

Code
PER-JOS-85
Mercy ID
V-03442-02
Encounter Date
11/02/2010
Last
Perez
First
Jose
DOB
06/21/1985
County
Fulton
Street
3815 MLK Union Dr. F-5
City
Atlanta
State
GA
Zip
30331-
Cell
(678) 882-9463
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Mendez
First
Deodora
DOB
07/02/1977
Address
N/A
Telephone
N/A
COB
Guatemala
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
YES
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
Fabiola Vazquez 01/08/2004 Mother w/Stepfather GA/USA
Herman Jr. Vazquez 08/26/2002 Mother w/Stepfather GA/USA
Natalia Mendez 01/08/2004 Mother w/Stepfather GA/USA
NOTES

Media Authoritation

DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
Fulton County Court