EFTA00003040.pdf
455 KB
Extraction Summary
1
People
2
Organizations
1
Locations
0
Events
1
Relationships
1
Quotes
Document Information
Type:
Emergency contact form / employment record
File Size:
455 KB
Summary
This document is a blank Emergency Contact Form for LSJE, LLC (associated with The Saint James Group in St. Thomas). The form has the Employee Name 'Peter Eli' filled in, but a handwritten note at the top states 'Declined to Complete,' and the rest of the fields remain empty. The company phone number is redacted.
People (1)
| Name | Role | Context |
|---|---|---|
| Peter Eli | Employee |
Name filled in on the Employee Name field of the Emergency Contact Form.
|
Organizations (2)
| Name | Type | Context |
|---|---|---|
| LSJE, LLC |
Company issuing the form; located in St. Thomas, VI.
|
|
| The Saint James Group |
Implied by the email address 'thesaintjames.group@gmail.com'.
|
Locations (1)
| Location | Context |
|---|---|
|
Address for LSJE, LLC printed on the form header.
|
Key Quotes (1)
"Declined to Complete"Source
EFTA00003040.pdf
Quote #1
Full Extracted Text
Complete text extracted from the document (915 characters)
Declined to Complete
LSJE, LLC
6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348
Phone: [REDACTED] E-mail: thesaintjames.group@gmail.com
LSJE, LLC
6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348
Phone: [REDACTED] E-mail: thesaintjames.group@gmail.com
Emergency Contact Form
Today's Date: [Blank]
Start Date: [Blank]
Employee Name: Peter Eli
Date of Birth: [Blank]
Start Date: [Blank]
Employee Name: Peter Eli
Date of Birth: [Blank]
Physical Address: [Blank]
Mailing Address: [Blank]
Mailing Address: [Blank]
Cell Phone: [Blank]
Phone (other): [Blank]
E-mail: [Blank]
Marital Status: [Blank]
Title/Position: [Blank]
Driver's License No: [Blank]
Phone (other): [Blank]
E-mail: [Blank]
Marital Status: [Blank]
Title/Position: [Blank]
Driver's License No: [Blank]
Allergies or Health Concerns: [Blank]
Blood type:
[ ] A- [ ] A+ [ ] AB- [ ] AB+ [ ] B- [ ] B+ [ ] O- [ ] O+ [ ] Unknown
[ ] A- [ ] A+ [ ] AB- [ ] AB+ [ ] B- [ ] B+ [ ] O- [ ] O+ [ ] Unknown
Current Medications: [Blank]
Doctor's Name: [Blank] Doctor's Phone: [Blank]
Doctor's Name: [Blank] Doctor's Phone: [Blank]
Doctor's Name: [Blank] Doctor's Phone: [Blank]
In case of emergency, please contact:
Name: [Blank] Relationship: [Blank] Phone: [Blank]
Name: [Blank] Relationship: [Blank] Phone: [Blank]
Name: [Blank] Relationship: [Blank] Phone: [Blank]
Name: [Blank] Relationship: [Blank] Phone: [Blank]
This information is for your safety and the safety of others.
EFTA00003040
EFTA00003040
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