ADA-AND-60

Code
ADA-AND-60
Mercy ID
V-00485-02
Encounter Date
06/13/2001
Last
Adan
First
Andres
DOB
05/21/1960
County
Dekalb
Street
1450-C Northcliff Valley Way
City
Atlanta
State
GA
Zip
30319-
Home
(404) 634-4294
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Zuñiga
First
Araceli
DOB
10/23/1964
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
YES
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
Andres Adan Zuñiga 08/03/1984 Parents GA/USA
Araceli Adan Zuñiga 07/27/1987 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
K. Aleman
Data Entry
K. Aleman
Referred By