ENR-JAV-82

Code
ENR-JAV-82
Mercy ID
V-03254-02
Encounter Date
02/09/2010
Last
Enriquez
First
Javier
DOB
08/06/1982
County
Dekalb
Street
2095 Burton Plaza Ln. Apt. K-10
City
Atlanta
State
GA
Zip
30319-
Cell
(678) 754-6324
Other
(678) 458-8345
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
YES
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
Javier de Jesus Enriquez 04/18/2002 Mother GA/USA
Yhogar Alejandro Enriquez 09/03/2009 Mother GA/USA

Former Spouse 1 Information

Last
Rocha
First
Graciela
DOB
09/24/1980
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
linea-Juana/Dekalb county