Case File
efta-01304179DOJ Data Set 10OtherEFTA01304179
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01304179
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
LSJE, LLC
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel:
04/10/18
Employee Name: James Cesar
Emergency Contact Form
Start Date:
05/04/17
Address:
Date of Birth:
Phone:
Cell:
E-Mail:
Title / Position: Ca,
Marital Status: Married
License:
Allergies or Hc,a!ti Co, •
• •-,t
Blood Type:
Current Medication:
Doctor's Name:
Doctor's Name:
Phone:
Phone:
In case of an Emergency, Please contact :
Name
Wisner Piern
Relationship
t
ame
Afred Piern
Relationship
Phone
Phone
This Information is for your safety and the safety of others
(NI
EFTA01304179
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