Case File
efta-efta01223121DOJ Data Set 9OtherEmployee Loan Request
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Unknown
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DOJ Data Set 9
Reference
efta-efta01223121
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1
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0
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Employee Loan Request
Date: 03/12/19
Company Name and Address:
LSJE, LLC
6100 Red Hook Quarter B3
St Thomas, VI 00802
Employee:
Dale Mark
Employed 05/14/18
I. The Employee hereby acknowledges a debt to the Company in the amount of One
Thousand Two Hundred Dollars ($1,200.00) for the following reason(s):
Need to replace transmission in personal vehicle.
2. The Employee hereby authorizes the Company to deduct the amount of One Hundred
Dollars ($100.00) per pay check, until the balance is paid in full. If Employee has available
funds he would request he could pay more per pay check.
3. The Employee further agrees that the entire outstanding amount will be deducted from the
Employee's paycheck upon resignation or termination of employment with the Company.
Signed in the month of March on the 12'h day of 2019.
Employee's Signature:
Company Signature:
Printed Name: Dale Mark
Printed Name: Stephanie Remington
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EFTA01223121
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