SIA-LIZ-69

Code
SIA-LIZ-69
Mercy ID
V-01049-01
Encounter Date
12/10/2002
Last
Siabato
First
Liz maribel
DOB
05/31/1969
County
Gwinnett
Street
900 Legacy Park Dr. Apt. 1631
City
Lawrenceville
State
GA
Zip
30043-
Home
(678) 376-5277
Cell
(770) 312-0482
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Perea
First
Tucisidides
DOB
09/06/1971
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
No
Driver
YES
Home Owner
No
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
Jonathan Perea 03/22/1994 Mother GA/USA
Juliana Perea 03/06/1999 Mother 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
K. Aleman
Referred By
x7764 Rebecca