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Emergency Contact Form for Employee Dorn B. Donissaint, LSJE LLC

This is an emergency contact form dated April 10, 2018, completed for employee Dorn B. Donissaint employed by LSJE, LLC, a company located in St. Thomas, U.S. Virgin Islands. The form captures employee personal information, health details, and emergency contact information for workplace safety purposes. Most personal details including phone numbers, email, date of birth, and emergency contact information are redacted.

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Document Transcript

EMERGENCY CONTACT FORM

Company: LSJE, LLC Address: 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802

Form Date: 04/10/18 Start Date: 04/10/18

EMPLOYEE INFORMATION: Name: Dorn B. Donissaint Address: St. Thomas, VI 00802 Date of Birth: [REDACTED] Phone: [REDACTED] Cell: [REDACTED] E-Mail: [REDACTED] Title/Position: Labor [partially visible] Marital Status: Married License: [BLANK]

HEALTH INFORMATION: Allergies or Health Concerns: [BLANK] Blood Type: Not specified Current Medication: [BLANK] Doctor's Name: [BLANK] / Phone: [BLANK] Doctor's Name: [BLANK] / Phone: [BLANK]

EMERGENCY CONTACTS: Name: [REDACTED] Relationship: Friend Phone: [REDACTED]

Name: [BLANK] Relationship: [BLANK] Phone: [BLANK]

Footer: "This Information is for your safety and the safety of others"

Names mentioned: - Dorn B. Donissaint — Employee of LSJE, LLC; position appears to be in labor/maintenance role

Frequently Asked Questions

What is "Emergency Contact Form for Employee Dorn B. Donissaint, LSJE LLC"?
This is an emergency contact form dated April 10, 2018, completed for employee Dorn B. Donissaint employed by LSJE, LLC, a company located in St. Thomas, U.S. Virgin Islands. The form captures employee personal information, health details, and emergency contact information for workplace safety purposes. Most personal details including phone numbers, email, date of birth, and emergency contact information are redacted.
Where does this document come from?
This document was released as part of the DOJ - Data Set 1 collection. All documents in this archive are sourced from publicly available U.S. government releases.
How long is this document?
This document contains 1 page and is available as a PDF file (462.6 KB).
Can I download this document?
Yes, this document is available for download or viewing in its original format. Use the "View Original" or "Download" buttons on this page to access the source file.
Document Details

Type

Other

Release Date

January 24, 2025

Pages

1

File Size

462.6 KB

Format

PDF

Data Set

data-set-1

OCR Confidence

100%

ID: EFTA00003051

Last updated: Apr 29, 2026

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