Employee Emergency Contact Form - LSJE LLC St. Thomas
This is an employee emergency contact form from LSJE, LLC (The Saint James Group), a business located in St. Thomas, Virgin Islands. The form is partially completed with handwritten entries but contains significant redactions. It appears to be a standard HR document used to collect employee personal information, emergency contacts, and health details for workplace safety purposes.
Document Transcript
EMERGENCY CONTACT FORM
Company: LSJE, LLC Address: 6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348 Email: thesaintjames.group@gmail.com
FIELD INFORMATION (as visible/legible): - Today's Date: 2/29/19 (handwritten) - Employee Name: [Redacted] - Physical Address: [Redacted] - Mailing Address: [Redacted] - Cell Phone: [Redacted] - Title/Position: [Redacted] - Start Date: [Redacted] - Date of Birth: [Redacted] - Phone (other): [Redacted] - Marital Status: [Redacted] - Driver's License No.: [Redacted] - Allergies or Health Concerns: [Redacted] - Current Medications: [Redacted] - Doctor's Name: [Redacted, appears twice] - Doctor's Phone: [Redacted, appears twice]
EMERGENCY CONTACTS: - Name: [Redacted] | Relationship: [Redacted] - Name: [Partially visible] | Relationship: [Redacted] | Phone: [Redacted]
Form footer states: 'This information is for your safety and the safety of others.'
NOTE: The reverse side of the form is heavily redacted with large black blocks obscuring most content.
Names mentioned: - Employee Name — Form subject - specific name redacted
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Type
OtherSource
DOJ - Data Set 1Release Date
January 24, 2025
Pages
1
File Size
465.8 KB
Format
Data Set
data-set-1
OCR Confidence
ID: EFTA00003041
Last updated: Apr 29, 2026
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