BEC-LET-74

Code
BEC-LET-74
Mercy ID
V-03454-01
Encounter Date
10/21/2010
Last
Becerra
First
Leticia
DOB
04/16/1974
County
Hall
Street
3201 Rose peal St.
City
Gainsville
State
GA
Zip
30507-
Cell
(770) 531-4388
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Apolinar
First
Mario
DOB
10/21/1974
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
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
Cinthia Apolinar 01/07/1995 Parents GA/USA
Emely Apolinar 02/10/2002 Parents GA/USA
Mariana Apolinar 04/19/1996 Parents GA/USA
Mario Apolinar 10/19/2004 Parents GA/USA
Rodrigo Apolinar 12/12/2006 Parents GA/USA
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- Griselda