RIV-NER-76

Code
RIV-NER-76
Mercy ID
V-03450-02
Encounter Date
11/02/2010
Last
Rivera
First
Nery
DOB
07/01/1976
County
Dekalb
Street
2569 New Heaven Dr. Apt. F
City
Atlanta
State
GA
Zip
30345-
Cell
(404) 934-6811
Family Status
Single adult
COB
Guatemala
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
No
Court Mandated
YES
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
YES
New Incident
YES
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
YES
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
Evelyn Nohemi Rivera 07/05/2001 Grandmother Guatemala-Paterna
Jefferson Alfredo Rivera 05/11/1997 Grandmother Guatemala -Materna
Nery Alexander Rivera 09/03/1998 Grandmother Guatemala-Materna

Former Spouse 1 Information

Last
Guevara
First
Berta
DOB
N/A
Telephone
N/A
COB
El Salvador
Home Owner
No

Former Spouse 2 Information

Last
L?????????????????????????????
First
L?????????????????????????????
DOB
N/A
Telephone
N/A
COB
Guatemala
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-Griselda/Asoc. Lat.-Dekalb Court