LSJE LLC Emergency Contact Form for Employee

LSJE, LLC 6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348 Phone: [redacted] E-mail: thesaintjames.group@gmail.com

EMERGENCY CONTACT FORM

Today's Date: [redacted] Employee Name: [REDACTED] Physical Address: [REDACTED] Mailing Address: St. Thomas, VI [REDACTED] Cell Phone: [redacted] Title/Position: [REDACTED] E-mail: [REDACTED] Start Date: [redacted] Date of Birth: [REDACTED] Phone (other): [redacted] Marital Status: [REDACTED] Driver's License No.: [REDACTED]

Allergies or Health Concerns: N/A - [REDACTED] Blood Type: Options shown - A-, A+, B-, B+, AB-, AB+, O-, O+, Unknown Current Medications: [REDACTED] Doctor's Name: [REDACTED] Doctor's Phone: [redacted] Doctor's Name (2): [REDACTED] Doctor's Phone (2): [redacted]

In case of emergency, please contact: Name: [REDACTED] Relationship: [REDACTED] Phone: [redacted]

Name: [blank] Relationship: [blank] Phone: [blank]

Note: This information is for your safety and the safety of others.

[Second page shows a heavily redacted form with multiple black bars covering most content, making specific details illegible]

Names mentioned: - Unknown Employee — Employee at LSJE LLC (name redacted) - [Emergency Contact - Name Redacted] — Listed emergency contact person