EFTA00003054.pdf
519 KB
Extraction Summary
3
People
2
Organizations
2
Locations
0
Events
3
Relationships
2
Quotes
Document Information
Type:
Employee emergency contact form
File Size:
519 KB
Summary
This document is an Emergency Contact Form for an employee named Gerry Titre, working in Maintenance for LSJE, LLC (an entity associated with Little St. James). Dated March 20, 2018, it lists his wife Valerie and daughter Gerrycia as emergency contacts, along with Red Hook Family Practice as his doctor. Several personal details including phone numbers and health information are redacted.
People (3)
| Name | Role | Context |
|---|---|---|
| Gerry Titre | Employee |
Maintenance worker filling out emergency contact form for LSJE, LLC
|
| Valerie | Emergency Contact |
Wife of Gerry Titre
|
| Gerrycia | Emergency Contact |
Daughter of Gerry Titre
|
Organizations (2)
| Name | Type | Context |
|---|---|---|
| LSJE, LLC |
Employer, likely an entity for Little St. James Estate
|
|
| Red Hook Family Practice |
Listed as Doctor's Name
|
Locations (2)
| Location | Context |
|---|---|
|
Address for LSJE, LLC
|
|
|
Employee's city of residence
|
Relationships (3)
Employee Name on LSJE, LLC form
Listed as Wife on emergency contact form
Listed as Daughter on emergency contact form
Full Extracted Text
Complete text extracted from the document (804 characters)
LSJE, LLC
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: [REDACTED] Fax: [REDACTED]
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: [REDACTED] Fax: [REDACTED]
Emergency Contact Form
Date: 03/20/18
Start Date: _________
Start Date: _________
Employee Name: Gerry Titre
Address: [REDACTED] St Thomas, VI 00802
Date of Birth: [REDACTED]
Date of Birth: [REDACTED]
Phone: _________
Cell [REDACTED]
E-Mail: n/a
Cell [REDACTED]
E-Mail: n/a
Title / Position: Maintenance
Marital Status: Married
License: _________
Marital Status: Married
License: _________
Emergency Information:
[REDACTED]
Allergies or Health Concerns:
[REDACTED]
Allergies or Health Concerns:
Blood Type: [REDACTED]
Current Medication:
Doctor's Name: Red Hook Family Practice
Phone: _________
Phone: _________
Doctor's Name: _________
Phone: _________
Phone: _________
In case of an Emergency, Please contact :
Name Valerie
Relationship Wife
Phone [REDACTED]
Relationship Wife
Phone [REDACTED]
Name Gerrycia
Relationship Daughter
Phone [REDACTED]
Relationship Daughter
Phone [REDACTED]
This Information is for your safety and the safety of others
EFTA00003054
EFTA00003054
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