Employee Emergency Contact Form - LSJE LLC, March 2018
This is an emergency contact form for an employee of LSJE LLC (a Limited Liability Company based in St. Thomas, VI) dated March 22, 2018. The form captures the employee's personal information, health details, emergency contacts, and physician information. Significant portions of the document are redacted, including the employee's address, date of birth, email, and emergency contact phone numbers.
Document Transcript
EMERGENCY CONTACT FORM
Company: LSJE, LLC Address: 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802
Start Date: 03/22/18
Employee Name: Borilace Loudat (alternately appears as "fivrilare Lot;da!" on first page) Address: [REDACTED] St Thomas Date of Birth: [REDACTED] E-Mail: [REDACTED]
Job Title/Position: Caretaker/Housekeeper Marital Status: Married License: [BLANK]
ALLERGIES OR HEALTH CONCERNS: None listed Blood Type: Unspecified
CURRENT MEDICATION: [BLANK]
DOCTOR'S INFORMATION: Doctor's Name: Douglas Phone: [BLANK] Doctor's Name: Douglas Phone: [BLANK]
EMERGENCY CONTACTS: 1st Contact - Relationship: Wife Name: [REDACTED] Phone: [REDACTED]
2nd Contact - Relationship: In Law Name: [REDACTED] Phone: [REDACTED]
Footer: "This Information is for your safety and the safety of others"
Names mentioned: - Borilace Loudat — Employee of LSJE LLC, position: Caretaker/Housekeeper, hired March 22, 2018 - Douglas — Physician/Doctor listed as primary and secondary doctor on emergency contact form
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Type
OtherSource
DOJ - Data Set 1Release Date
January 24, 2025
Pages
1
File Size
495.6 KB
Format
Data Set
data-set-1
OCR Confidence
ID: EFTA00003043
Last updated: Mar 9, 2026
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