Employee Emergency Contact Form - Felilo Joseph, LSJE LLC

EMERGENCY CONTACT FORM

Business: LSJE, LLC Address: 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Telephone: 340-775-8100 Fax: 340-775-8108

Form Date: 06/14/18 Employee Start Date: [Not visible]

EMPLOYEE INFORMATION: - Name: Felilo Joseph - Address: [REDACTED] - Date of Birth: [REDACTED] - Phone: [REDACTED] - Cell: [REDACTED] - E-Mail: [Not provided] - Title/Position: [Partially redacted] - Marital Status: Single - Driver's License: [Not provided]

HEALTH INFORMATION: - Allergies or Health Concerns: [Not provided] - Blood Type: [REDACTED] - Current Medication: [Not provided] - Doctor's Name: [Not provided] - Doctor's Phone: [Not provided] - Second Doctor's Name: [Not provided] - Second Doctor's Phone: [Not provided]

EMERGENCY CONTACTS: 1. Name: Jennifer Relationship: Girlfriend Phone: [REDACTED]

2. Name: Fay Relationship: Sister Phone: [REDACTED]

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

Names mentioned: - Felilo Joseph — Employee of LSJE, LLC; form subject - Jennifer — Emergency contact listed as girlfriend - Fay — Emergency contact listed as sister