DOJ Epstein Files, Data Set 1 (EFTA00003035)

	LSJE, LLC
Phone	6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348 E-mail: thesaintjames.group@gmail.com
	Emergency Contact Form

40 Today’s Date:	Start Date:
CHARLES DICK Employee Name:	Date of Birth:
Physical Address:	T. THOMAS USUI a
Mailing Address:
Cell Phone:	Phone (other):
E-mail:	Marital Status: 0
Title/Position:	Driver’s License No:

Allergies or Health Concerns:
Blood type:
A- A+ AB- AB+	B- B+ 0- 0+ Unknown
Current Medications: N
Doctor’s Name: N	Doctor’s Phone:
Doctor’s Name:	Doctor’s Phone:


In case of emergency, please contact:
Name: Relationship:	CIEN Phone:

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EFTA00003035