EFTA01221435.pdf

LSJE LLC 6100 Red Hook Quarter 83 St. Thomas, VI 00802-1348 May 8, 2015 Mr. Angel Feliciano SI Dear Mr. Feliciano: Please be advised that your employment with LSJE, LLC (the "Company") has been terminated, effective May 5, 2015. Your termination is a result of a number of factors, including but not limited to: (1) your repeated absences without proper notice despite warnings and reminders from your supervisors about proper procedure regarding absences; (2) your failure to perform an employment related duty specifically requested multiple times by your supervisor; (3) the improper or careless performance of your employment related duties; (4) hydraulic fluid discovered to have been improperly introduced into inappropriate portions of equipment under your care; and (5) your disregard of explicit directions from your supervisor. We remind you that you signed a confidentiality agreement with the Company, which will remain in full force and effect and with which you are obligated to comply, even though your employment has been terminated. We have enclosed a check in the amount of $1348.82, representing full payment of all outstanding wages due to you through the date of termination. We are making this payment without offset for any damages sustained by the Company as a result of your misconduct with the intention that this will assist in the final termination of our relationship without further issue. Should you not share this intention, please be advised that this payment is without prejudice to any and all rights and claims of the Company against you, all of which are hereby expressly reserved. Sincer t p e Rodri eez Received by:i Angel Feliciano EFTA01221435 JUN. 30. 2015 3:55PM DEPT OF LABOR NO. 5166 P. 1 GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS • DEPARTMENT OF LABOR DIVISION OF UNEMPLOYMENT INSURANCE NOTICE OF HEARING NOTE: The Agency's record will be made CLAIMANT: Angel Feliciano part of this hearing. Date of Mailing: June 30, 2015 Determination Date: June 3, 2015 Liable State: VI SSN# Appellant (X) Claimant 0 Employer EMPLOYER: LSJE, LLC REFEREE: James W. Kitson 6100 Red Hook Quarter 8-3 Administrative Law Judge St. Thomas, VI 00802 Issue: Misconduct APPEAL NO. 061-01-15 You are hereby notified to appear for a hearing on a determination issued by the Virgin Islands Employment Security Agency, St. Thomas, United States Virgin Islands. Please mail two copies of any exhibits before the hearing date, allowing sufficient time for the mail to: James W. Kitson, Administrative Law Judge, Dept. of Labor, Hearings and Appeals • Unit, P.O. Box 302608, Charlotte Amalie, St. Thomas, V.I. 00803 PLEASE BE PROMPT (Please appear in person at the address below) DATE: July 6, 2015 TIME: 12:00 p.m. PLACE: Department of Labor 2353 Kronprindsens Gade St. Thomas, VI 00802 PHONE: Administrative Law Judge If contact cannot be made with the St, iThomas Hearioes& 'Aeneas Unit, please contact. •Itentativelv. St. Croix RearinoS and Appeals at 340:1773-1994. Due to federal guidelines regarding the prompt disposition of appeal cases, postponements can only be granted for emergency reasons. If you are handicapped as defined in Section 405 of the Rehabilitation Act of 1973, please call the department at the above telephone number. PLEASE REFER TO INSTRUCTIONS TO THE CLAIMANT AND EMPLOYER a P.O. Box 789 Christiansted, St. Croix, V.1.00821{ O 4401 Sion Farm Ste. 1, Christiansted, St. Croix, V 0 2353 KronprIndsens Gada, St. Thomas, VI 00802 ❑ P.0. Box 303159, Charlotte Amalie. St. Thomas. V EFTA01221436 JUN. 30. 2015 3:55PM DEPT OF LABOR NO. 5166 P. 2 GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS • DEPARTMENT OF LABOR DIVISION OF UNEMPLOYMENT INSURANCE INSTRUCTIONS TO THE CLAIMANT REASON FOR THIS HEARING: The hearing is being held to give you a chance to present your evidence and your side of the case at or near your place of residence. SUBJECT OF THE HEARING: The hearing will cover the decision listed and may include all questions affecting your right to benefits up to the time of the hearing. APPEARANCE: If you do not appear at the hearing, your appeal may be dismissed or it may be decided on the basis of other available evidence. POSTPONEMENT: This hearing will be postponed only for good cause. Postponement must be requested In writing. If an emergency arises directly prior to scheduled time, and you cannot come to the hearing, notify the place of hearing. (Telephone Number shown on Notice of Hearing) WITNESSES: If you have any witnesses whom you wish to have testify at the hearing, it is your duty to notify them of the TIME and the PLACE of the hearing and arrange for them to be present. REPRESENTATIVES: You may appear at the hearing without representation. However, if you wish, you may be represented by an attorney or anyone else you select. Such attorneys or other authorized agent shall not charge the claimant or receive from him a fee in excess of five percent of the claimant's maximum potential benefits provided for in section 303 (d) of the Act. IF YOU WISH TO WITHDRAW YOUR APPEAL: Send a written request to: Virgin Islands Employment Security Agency, Unemployment Insurance Service, P.O. Box 9650, St. Thomas, Virgin Islands 00801. BRING WITH YOU TO THE HEARING: This notice, all statements, decisions, forms and letters that are connected with your claim; any witnesses whose testimony you need to help you prove your case; all papers and books that are connected with this case. In cases involving health, a doctor's certificate may be important. • P.O. Box 789 Christiansted, St. Croix, V.I. 00821 O 4401 Sion Farm, Sto. 1, Christiansted, Si. Croix, O 2353 Kronprindsens Gade, St. Thomas, VI 0080 O P.O. Box 303159, Charlotte Amalie, St. Thomas, EFTA01221437 JUN. 30. 2015 3:56PM DEPT OF LABOR NO. 5166 P. 3 GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS • DEPARTMENT OF LABOR DIVISION OF UNEMPLOYMENT INSURANCE INSTRUCTIONS TO EMPLOYERS REASON FOR THIS HEARING. This hearing is being held to obtain facts pertinent to the claimant's eligibility for unemployment insurance benefits. SUBJECT OF THE HEARING: The hearing will cover the decision listed below and may include all questions affecting rights to benefits up the time of the hearing. POSTPONEMENT: This hearing will be postponed only for good cause. Postponement must be requested in writing. If an emergency arises directly prior to scheduled time, and you cannot come to the hearing, notify the place of hearing. (Telephone Number shown on Notice of hearing). WITNESSES', If you have any witnesses whom you wish to have testify at the hearing, it is your duty to notify them of the TIME and the PLACE of the hearing and arrange for them to be present. REPRESENTATIVES: You may appear at the hearing without representation. However, if you wish, you may be represented by an attorney or anyone else you select. BRING WITH YOU TO THE HEARING: This notice, all statements, decisions, forms and letters that are connected with this matter; any witnesses whose testimony you need to help you present your case; all papers and books that are connected with this case. ❑ P.O. Box 789 Christiansted, St Croix, V.1.008214340) (340) 773-1994: Fax: (340) 773-0094 ❑ 4401 Sion Farm, Sta. 1, Christiansted, St Croix, V.I. 00820 - (340) 773-1994: Fax: (340) 773-0094 O 2353 Kronprindsens Cade, St Thomas, VI 00802 - (340) 776-3700: Fax: (340)774.5908 O P.O. Box 303169, Charlotte Amalie. St. Thomas, VI 00803 -(340) 778-3700: Fax: 774-5908 EFTA01221438  JUN. 30. 2015 3:56PM DEPT OF LABOR NO. 5166 P. 4 NOTICE Or APPEAL CLAIMANT: DO NOT WRITE IN IM Box. 6. SOD 1, NAME cl <i il • UCFE 0 UCX 0 ewe 0 OTHER T. (A) LIABLE STATF 3, if you are planning b Change your oRicem, eomoRto Dv !flowing; Beginning my new address will be (0) TRANSPERRINGt STATE tr P. (A) . APPEAL FROM: IA A S 0 _Mau 0* (issue) (1) DaterminatIon . a. I appeal and request a hearing for me following reason(s): Redetermination 0 (2) 1Si 5ckyree • in (3) s Decision (B). Wilith we: dated m ap,t /mo t( (C) Handed to Claimant (Dated) ( 3) Mailed to Claimant (doStmaric date) 9. APPEAL PILED: (A) laCperson on ---\-3- 4 A--c .1( )apt.5 (B) 0" Maio (1) Postmark Date (2) Receipt pate 10. STAKER' 'SNAIL/RE a ...... 0 ....- J 1 R USE OF LIABLE STATE —5rYou - may- atten4- rhearing - In- thts- State- orin - the- State- agalnst— which you arc appealing, in, wNelt State do YOU Olen to attend a hearing? • •• . 12- LOCAL OPTICS. ADDRESS AND NUMBER (Uso Stable() DeirotiOUTION: Original Liable State/Transferring State Duplicate Agent State - Appeals Unit (Attach copy of Determination( Triplicate Agent State - Local Office Quadruplicate Claimant's Copy IR 101 (Juno 1978) Virgin Islands— 78 EFTA01221439  30.2015 3:56PM DEPT OF LABOR NO. 5166- P. 5- V\../..0 Islands Employment Security Age y Unemployment Insurance Service Type of Claim NOTICE OF NONMONETARY DETERMINATIO UI N LocalOffice 001 OR REDETERMINATION Adj. No. 23 Claimant S. S. No. 1-9220 THIS DETERMINATION IS FINAL UNLESS AN APPEAL IS FILED WITHIN 10 DAYS OF THIS ANGEL L. FELICIANO Date Wednesday, May 20, 2015 Date Decision is Final Monday, June 01, 2015 Issue Misconduct The following determination has been made on your claim: You are not entitled to unemployment insurance benefits from 05/17/2015: the week in which you left work and beginning with the first day of the week following the week in which the separation occurred until you have worked in at least four subsequent weeks (whether or not consecutive) and earned not less than four REASON FOR DECISION: _ On your intake application form, you selected "lack of work" as the separation reason from your job. It was later noted that you were terminated for a number of factors, as stated by your employer. Some of these factors include your disregard of explicit directions from your superior, and your repeated absences despite several warnings and reminders. Misconduct has been established in this case. Your employer had a right to expect a certain standard of conduct by you that was undisplayed. enefits are denied. This determination is in accordance with Section 304, Subsection b, Paragraph 3 of the Virgin Islands Unemployment Insurance Act as amended on September 3, 1981, September 17, 1982, September 29, 1983, July 30, 1984 and December 19, 1984. NOTICE TO EMPLOYER: This determination is furnished for your information FL— SJ Employees, LLC 6100 Red Hook Quarters, B-3 St. Thomas VI 00802 1348 DEPARTMENT OF LABOR *Reply to UNEMPLOYMENT LNUSRUANCE (For appeal rights see reverse of this notice) virgin Islands Form tUB-fl EFTA01221440  LSJE, LLC Mailing Address: 6100 Red Hook Quarter B3 St. Thomas, VI 00802-1348 General contact information Tel: 340-775-8100 Fax: 340-775-8108 E-mail: Accounts payable department contact information Faxes Employee Warning Notice Employee Name kiANO Date: Position. Reek/M C Department. liffirsilVarnffig / / Second Warning I / Third Warning Nature of Infraction: I IR ness to Employees or Supervisor I I Insubordination I I Abandonment of post I nexcused Absence I I Incompetence I I Conduct Unbecoming I I Excessive Absenteeism I I Neglect of Duty I I Abusive Behavior Lateness/Early Quit I I Poor Workmanship I IOTHER: Previous Warnings: ORAL WRITTEN, .. DATE BY WHOM Is' Warning IV . / I Peteetedc, "nil rd Warning 3rd Warning SUPERVISOR'S DESCRIPTION OF INFRACTION: EMPLOYEE STATEMENT: Dait of I,nIractipn• Ti pi. I I I agree with Employer's statement. (...Wifil ti'624- - 8,103;AJ Na- AS 51$006:41 I I disagree with Employer's description of the an 14ltroAti I ft infraction for the following reasons. Description of Action to be taken: arning I I Probation I I Suspension I I Dismissal I I Other I have read this Warning Notice and 1 understand it. Signature of Employee Date Signature of Witness Date EFTA01221441  LSJE, LLC Mailing Address: 6100 Red Hook Quarter B3 St. Thomas, VI 00802-134 ntact information Tel: 340-775-8100 Fax: 340-775-8108 E- •• • Accounts payable department contact informatio t Fax: 340-775-2528 Employee Warning Notice Employee Name: I 12/iciAao Date: Position: /1€ Atot Department: • / / First Warning / 0-. cord Warning / / Third Warning Nature ofInfr • sliont II Rydeness to Employees or Supervisor I I Insubordination I I Abandonment of post l yl nex sed Absence I I Incompetence I I Conduct Unbecoming essive Absenteeism Neglect of Duty I I Abusive Behavior teness/Early Quit I I Poor Workmanship I I OTHER : Previous Warnings: ORAL WRITTEN DATE BY WHOM I" Warning I 2" Warning 1"------ Viiit I ii PI I Allot-1 Ea r. I 3rd Warning I I SUPERVISOR'S DESCRIPTION OF INFRACTION: EMPLOYEE STATEMENT: Date Infr e tip7 Time- I I I agree with Employer's statement. --t-hs EX 41 /.3 Ai d124/•07---- I I I disagree with Employer's description of the ii€ ha Davtist atom Ato infraction for the following reasons. cal/1 Nn Shn I //1 Tate . Description of Action to be taken: timing I I Probation I I Suspension I I Dismissal I I Other I have read this Warning Notice and I understand it. Signature of Employee Date Sighatgx of Supervisor Signature of Witness Date EFTA01221442  LSJE, LLC Mailing Address: 6100 Red Hook Quarter B3 St. Thomas, VI 00802-1348 General contact information Tel: 340-775-8100 Fax: 340-775-8108 E-mail. Accounts payable department contact Information Employee Warning Notice Employee Name. /lid &Le/AND Date: Position: Department. I I First Warning I Second Warning lewd Warning Nature of Infraction; eness to Employees or Supervisor nsubordination I I Abandonment of post cused Absence I I Incompetence I I Conduct Unbecoming I xcessive Absenteeism I I Neglect of Duty I I Abusive Behavior I I Lateness/Early Quit I I Poor Workmanship I I OTHER : Previous Warnings: ORAL WRITTEN DATE BY WHOM Im Warning 2n° Warning 3" Warning t .-- I tiltijd ././ Oe' lam. SUPERVISOR'S DESCRIPTION OF INFRACTION: EMPLOYEE STATEMENT: oDID foor tqfr gtio Tiqe• I I I agree with Employer's statement. ( I fitacti op 4O I disagree with Employer's description of the 0.00/2 on V hio Solyd infraction for the following reasons. In) 52 cze oor t dify ro‘ Visa- o 44.94 LtIouleta04- s 4th 4.r) woe OR Conic At Description of Action to be taken: I arning I Probation I I Suspension I I Dismissal I I Other I have read this Warning Notice andI understand it. Signature of Employee Date Signature of Witness Date EFTA01221443  LSJE, LLC Mailing Address: 6100 Red Hook Quarter B3 St. Thomas, VI 0 - ntact information Tel: 340-775-8100 Fax: 340-775-8108 E- •• Accounts payable department contact information Fax: Employee Warning Notice Employee Name: Date: / h - ca do Position- Department: 1 I First Warning 1 I Second Warning I / Third Warning bovE3 WR14;41 14 /5 Nut u re of Infraction; i I Rutoess to Employees or Supervisor Pir rdination I I Abandonment of post I ii used Absence I ncompetence I Conduct Unbecoming I .I.Eiccessive Absenteeism I I Neglect of Duty I I Abusive Behavior I I Lateness/Early Quit I I Poor Workmanship OTHER: Previous Warnings: ORAL WRITTEN DATE __,.....fi y. M Y' / / ( --- -s*Ca r 2i0 Warning 3rd Warning III q IS IS I /21 -- „,„ ,,„, jer SUPERVISOR'S DESCRIPTION OF INFRACTION: EMPLOYEE STATEMENT: Datnoif Infra: 520 n: . Time:_e_ I I I agree with Employer's statement. pirabiar Foca, tattathisia, s eine/ I I I disagree with Employer's description of the <7/ 0 r I Aga:VA' 6 ritlh II/Dr.htity infraction for the following reasons. WAS p ‘4117. Description of Action to be taken: I Warning I I Probation I I Suspension I Other I have read this Warning Notice and I understand it. Signature of Employee Date r) Signature of Witness Date EFTA01221444  LSJE, LLC Mailing Address: 6100 Red Hook Quarter B3 St. Thomas, VI 00802-1348 General contact information Tel: 340-775-8100 Fax: 340-775-8108 E-mail: Accounts payable department contact information Fax: Employee Warnin Notice Finnlo)ee Name: I fi litiAnt Date: Position: Department: I I First Warning I / Second Warning I I Third Warning Nature of Infraction: I I Rudeness to Employees or Supervisor I I Insu rdination I I Abandonment of post I I Unexcused Absence I c nee I I Conduct Unbecoming I I Excessive Absenteeism Ipecac Duty I I Abusive Behavior I I Lateness/Early Quit Iskroor Workmanship I IOTHER: Previous Warnings: ORAL WRITTEN DATE BY WHOM 10 Warning 1 2id Warning 3s Warning SUPERVISOR'S DESCRIPTION OF INFRACTION: EMPLOYEE STATEMENT: Dtif e of 4:fraction Time. I I I agree with Employer's statement. lilt i) ;t1S WAHP ArI I I I disagree with Employer's description of the h ir tro , g • °Mk,- iti) St -v_ infraction for the following reasons. .5/m4d its4 A' 'tuft CHAR ;Mod y9 v ' • It T ail, Aim i s MCAP+ clik i4- F , r will Le4- him33o. No No 5 6/5/13 Description of Action to be taken: I I Warning r I Probation I I Suspension I Ittirnissal f I Other I have read this Warning Notice and I understand it. H Signature of Employee Date Si `Supervisror Date Signatureof Witn Date EFTA01221445  LSJE, LLC Mailing Address: 6100 Red Hook Quarter B3 St. Thomas, VI 00802-1348 General contact information Tel: 340-775-8100 Fax: 340-7754108 E-mail: Accounts payable department contact information Employee Warning Notice Employee Name: Position: 4 anie rclin;44O Department: Date: 5/346 I I First Warning I I Second Warning / / Third Warning Nature of Infraction: I Rudeness to Employees or Supervisor I I Insubordination I I Abandonment of post I I Unexcused Absence I I Incompetence I I Conduct Unbecoming Excessive Absenteeism I I Neglect of Duty I I Abusive Beh)viir I I Lateness/Early Quit I I Poor Workmanship I OTHER : OW4 Previous Warnings: ORAL WRITTEN DATE BY WHOM la Warning Ps Warning 3rd Warning SUPERVISOR'S DESCRIPTION OF INFRACTION: EMPLOYEE STATEMENT: of In r cti n• Time. I I I agree uith Employer's statement. ld I I I disagree with Employer's description of the infraction for the following reasons. dLj our #r atm Description of Action to be taken: I I Warning I Probation I I Suspension IKCnissal I Other I have read this Warning Notice and I understand it. Signature of Employee Date gnature S# 1Cid e_ of Date EFTA01221446  This iS to cerli.Iy that /11--f has been inkier 111\ Irt` 10, Return: • I L----t-v4 Signature: c. (-\--()-(4,44.6 EFTA01221447 < Messages (6) Angel -LSJ Details Text Message Wed, Apr 8, 8:53 AM 4( Call mi En,Apr 1 - 0,7:16AM Please call me or Danny next time if your calling out sick, late or whatever. Thank you, Anna Mon, Apr 13, 6:10 AM Dentist appointment today Tue, Apr14-, i 1: 10 AM Send EFTA01221448  No call, no show again. I'm not sure what's going on? I think you should call by 12pm if you would like to keep your job. Boat captain not your Supervisor Danny or Manager. *You texted me you have a Dentist Appointment EFTA01221449 .900o AT8,- 7:59 AM 81% OD All Missed Edit Angel #2 LSJ (3) mobile Carlos- LSJ mobile Angel -LSJ (2) mobile BOBO -LSJ mobile Carlos- LSJ mobile 0 Karl mobile 0 Antonio/Chico mobile Moon (3) Yr. , .1,i) mobile 000 000 000 o_cP Recents Contacts Keypad Wk.:email EFTA01221450 *No call, No show Friday 4/10/2015 You called the Boat captain not your Supervisor Danny or Manager. *You texted me you have a Dentist Appointment Monday 4/13/2015 *No call, No show Tuesday 4/14/2015 *No call, No show Wednesday 4/15/15 No call, no show again. I'm not sure what's going on? I think you should call by 12pm if xini i ‘Arni ilrl hien +n 1ennr-, EFTA01221451 < Messag s (6) Angel #2 LSJ Detai McindaY4/13/2015 *No call, No show Tuesday 4/14/2015 *No call, No show Wednesday 4/15/15 No call, no show again. I'm not sure what's going on? I think you should call by 12pm if you would like to keep your job. This is insubordination. Wednesday 7:28 AM Mon you left early. Tues No call, No show Wednesday No call, No show. Send EFTA01221452  RECEIVED gin Islands Employment Security AL ,cy Unemployment Insurance Service MAY 2 2015 Type of Claim NOTICE OF NONMONETARY DETERMINATION UI OR REDETERMINATION LocalOffice 0CII_. Adj. No. 23 Claimant S. S. No. THIS DETERMINATION IS FINAL UNLESS AN APPEAL IS FILED WITHIN 10 DAYS OF THIS ANGEL L. FELICIANO Date Wednesday, May 20, 2015 Date Decision is Final Monday, June 01, 2015 Issue Misconduct The following determination has been made on your claim: You are not entitled to unemployment insurance benefits from 05/17 /2015, the week in which you left work and beginning with the first day of the week following the week in which the separation occurred until you have worked in at least four subsequent weeks (whether or not consecutive) and earned not less than four REASON FOR DECISION: On your intake application form, you selected "lack of work" as the separation reason from your job. It was later noted that you were terminated for a number of factors, as stated by your employer. Some of these factors include your disregard of explicit directions from your superior, and your repeated absences despite several warnings and reminders. Misconduct has been established in this case. Your employer had a right to expect a certain standard of conduct by you that was undisplayed. Benefits are denied. This determination is in accordance with Section 304, Subsection b, Paragraph 3 of the Virgin Islands Unemployment Insurance Act as amended on September 3, 1981, Septe mber 17, 1982, September 29, 1983, July 30, 1984 and December 19, 1984. NOTICE TO EMPLOYER: This determination is furnished for your information R s, Employees, LLC 6100 Red Hook Quarters, B-3 1 St. Thomas VI 00802 1348 DEPARTMENT OF LABOR Reply to UNEMPLOYMENT INUSRUANCE (For appeal rights see reverse of this notice) Virgin Islands Fenn UIB-53 EFTA01221453  SECTION 304 of the Virgin Island, . nemploym ent Insurance Act as ame. ed September 3, 1981, September 17, 1982, September 29, 1983, December 12, 1983, July 30, 1984 and December 19, 1984, provi des: (b) An insured worker shall not be disqualified for waitin g-week credit or benefits for any week of his unemployment unless with respect to such week the Commissioner fmds that: (3) he was discharged for misconduct connected with his most recent work, in which case he shall be disqualified for the week in which he was discharged and beginning with the first day of the week following the week in which he was discharged until he has worked in at least four subsequent weeks (whether or not consecutive) and earned not less than four times his weekly benefit amount. § 305. Determinations, notices, and payment of benef its—Payment of benefits Notice by employing unit (c) An employing unit having knowledge of any facts which may affect an individual's right to waiting- week credit or benefits shall notify the Director of such facts promptly, in accordance with regulations prescribed by the Commissioner of Labor. (3) The last employing unit which employed a claimant shall be entitled to receive written notice of a determination only if it has furnished information to the Comm issioner in accordance with subsection (c) of this section prior to such determination. Finality of determination (f) A determination shall be deemed final unless a party entitl ed to notice thereof applies for reconsideration of the determination or appeals therefrom withi n 10 days after the notice was mailed to his last known address or otherwise delivered to him; Provi ded, that such period may be extended for good cause. A party entitled to notice of a determination may, within the aforesaid time limits, at his option, appeal from such determination without first apply ing for reconsideration thereof. APPEAL RIGHTS If you do not agree with this determination, you are entitled to file a request for reconsideration or an appeal within ten (10) calendar days from the date of this notice. Your request shoul d be filed in person or in writing through your local claims office. LOCAL OFFICE ADDRESSES ST. THOMAS/ST. JOHN Physical Address: Department of Labor Mailing Address: Unemployment Insurance Division PO Box 303159 2353 Kronprindsens Gade St. Thomas, VI 00803 St. Thomas, USVI Telephone Number: (340) 776-3700 Fax Number: (340)714-4995 Physical Address: Department of Labor ST. CROIX Telephone Number: (340)773-1994 Unemployment Insurance Division Fax Number: (340)773-1515 4401 Sion Farm Christiansted, St. Croix USVI Hours are: 8:00 AM - 5:00 PM Monday through Friday EFTA01221454  Virgin Islands Department of Labor Vice of Unemployment Insurance Compen on • Date: 05-11.2015 Request for Separation Information Due Date: 05-20-2015 Please answer the following questions and return to the Local Office (listed below) by: 05-20-2015 This claimant applied for Unemployment Insurance Benefits on 05.11.2015 and named you as their last employer: Employee's Name: ANGEL L. FELICIANO Employee's SSN: Employer's Name & Address: 18125 LSJE, LLC 6100 RED HOOK QUARTER 8-3 CHARLOTTE AMALIE, VI 00802 NOTE: The Law provides penalties for false statements. REASON FOR SEPARATION [ Discharged ) Lack of Work / Layoff [ ] Leave of Absence 1 J Labor Dispute ( ) Voluntary Quit [ J Other (are there any other reasons for separation?) Submit additional facts that may affect the claimant's rights to benefits on the reverse side of this form. If this form is returned and you have indicated facts that may affect this person's eligibility for benefits, you will be notified In writing of the Agency's decision. Sce rcvcrxf REPORTED SEPARATION EARNINGS Since the last day worked, has the claimant received, or will he/she receive one of the following: . 1. Pension or any other retirement payment? [ J YES No If yes, please indicate effective date and amount: Effective Date: $ per month amount -or- $ lump sum pension amount 2. Severance or any other separation earnings? [ ] YES (1(N0 If yes, please indicate type of pay and amount: [ ) Severance $ lump sum severance amount [ 1 Vacation S lump sum vacation amount f ] Other lump sum other amount 3. Please indicate the following from your records: First Day Worked ir/ "S .0 obi Last Day Worked • NOTICE OF INTERVIEW If the claimant's reason for separation Is other than "lack of work", the claimant will be scheduled for a Fact Finding Interview on at the local office listed below. You will be contacted if additional information is requi