EFTA00003038.pdf

VOL00001 1 pages 13 redactions 9.4% redacted

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Page 1 13 redactions 100% OCR confidence 
LSJE, LLC 
6100 Red Hook uarters, Suite B-3, St. Thomas. VI 00802-1348
Phone: 
E-mail: thesaintjames.group@gmail.com 
Emergency Contact Form 
Today's Date: 
Li_ _ 14 
— 7_0 17 
Employee Name: I 
ii(c 
Beiyhrt.S.6244 
Physical Address: 
Mailing Address: 
Cell Phone: 
E-mail: 
Title/Position: 
Allergies or Health Concern I NI
Start Date: 
Date of Birth: 
3 - `1,5 -2-o lc/ 
-5C151-0, 
Phone (other): 
Marital Status: 
Driver's License No: 
Current Medications: 
4
Doctors Name: 
Doctors Name: 
Doctors Phone. 
Doctors Phone: 
in case of emergency, please contact: 
Name 
—
1, 
Phone: 
Relationship —1-1Ce 4C1 
Nam, 
Phone: 
I 
Relationship: 12 foth e y 
j 
This information is for your safety and the safety of others. 
EFTA00003038
Page 1 - Position (200, 171)

Size: 58 x 16 pixels

Surrounding text: Line $100 Red Hook Quarters, S hone: E-m Ern

Guess: [Short text - possibly name or number] unknown_short 20%
Small redaction (~6 chars)
Page 1 - Position (375, 269)

Size: 88 x 14 pixels

Surrounding text: Birth: nav 1.5.19.7

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Small redaction (~9 chars)
Page 1 - Position (152, 295)

Size: 137 x 17 pixels

Surrounding text: Name: maurice Bedminster ddress: St dress:

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Page 1 - Position (152, 318)

Size: 160 x 22 pixels

Surrounding text: a

Guess: [Short text - possibly name or number] unknown_short 20%
Small redaction (~17 chars)
Page 1 - Position (151, 349)

Size: 170 x 51 pixels

Surrounding text: St Phone Marita Driver

Guess: [Phone number] phone_number 80%
Context contains 'phone' suggesting Phone number
Page 1 - Position (394, 409)

Size: 102 x 28 pixels

Surrounding text: Single No:

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Small redaction (~11 chars)
Page 1 - Position (80, 490)

Size: 350 x 34 pixels

Surrounding text: Blood type: Current Medications: NA

Guess: [Medium text - possibly address or description] unknown_medium 20%
Medium redaction (~38 chars)
Page 1 - Position (385, 566)

Size: 127 x 24 pixels

Surrounding text: none: none:

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Small redaction (~14 chars)
Page 1 - Position (100, 604)

Size: 67 x 19 pixels

Surrounding text: Doctor's Name: In case of emergency, please CC

Guess: [Short text - possibly name or number] unknown_short 20%
Small redaction (~7 chars)
Page 1 - Position (118, 660)

Size: 65 x 20 pixels

Surrounding text: case of emergency, please contac lame: lame:

Guess: [Short text - possibly name or number] unknown_short 20%
Small redaction (~7 chars)
Page 1 - Position (410, 668)

Size: 110 x 61 pixels

Surrounding text: hone: hone: others.

Guess: [Phone number] phone_number 80%
Context contains 'phone' suggesting Phone number
Page 1 - Position (117, 689)

Size: 68 x 20 pixels

Surrounding text: lame: This in

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Small redaction (~7 chars)
Page 1 - Position (556, 755)

Size: 15 x 23 pixels

Guess: [Short text - possibly name or number] unknown_short 20%
Small redaction (~1 chars)
Extracted image

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photograph
1152 x 769

Possible photograph

People Mentioned

No people identified

Places Mentioned
Document Info
File Path
VOL00001/IMAGES/0004/EFTA00003038.pdf
File Size
442 KB
Processed
2025-12-21 04:50
Status
completed