VEG-RIC-66

Code
VEG-RIC-66
Mercy ID
V-03294-01
Encounter Date
03/25/2010
Last
Vega
First
Ricarda
DOB
04/03/1966
County
Gwinnett
Street
419 Hurican Shoals Road. Apt. A-2
City
Lawrenceville
Probation Officer/Caseworker
0045
State
GA
Zip
30045-
Cell
(678) 608-8850
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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
Jazmin Lopez 07/05/2003 Mother GA/USA
Jesus Lopez 07/11/2006 Mother GA/USA
Jose Alfredo Lopez 08/30/1998 Mother GA/USA

Former Spouse 1 Information

Last
Lopez
First
Jose
DOB
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana