CAR-JAV-77

Code
CAR-JAV-77
Mercy ID
V-02558-02
Encounter Date
09/18/2007
Last
Carmona
First
Javier
DOB
04/30/1977
County
Fulton
Street
1016 Hampton Ridge
City
Norcross
State
GA
Zip
30093-
Cell
(678) 683-1479
Family Status
Adult couple-no children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Roman
First
Amada
DOB
09/03/1980
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
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
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
Jaxiri Carmona 01/17/2004 Grandmother Mexico
Jovanna Carmona 10/29/1996 Grandmother Mexico
Odaly Carmona 11/25/1998 Grandmother Mexico
Roxani Carmona 10/27/2000 Grandmother Mexico
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
Fulton-Court