LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas. VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 Date: 03/16/1B Employee Name: Justina de Is Cruz Emergency Contact Form Start Date: Address: Date of Birth: Phone: Cad E-Mail: Title / Position: Housekeeper Marital Status: Marred License:

LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas. VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 Date: 03/16/1B Employee Name: Justina de Is Cruz Emergency Contact Form Start Date: Address: Date of Birth: Phone: Cad E-Mail: Title / Position: Housekeeper Marital Status: Marred License:

LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas. VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 Date: 03/16/1B Employee Name: Justina de Is Cruz Emergency Contact Form Start Date: Address: Date of Birth: Phone: Cad E-Mail: Title / Position: Housekeeper Marital Status: Marred License: