VI Elections

I hereby swear (or affirm) that I am a citizen of the United States, that I am not a registered voter in any other state or territory of the United States or in any foreign country or in any other election district, that on the day of the next election I shall be at least 18 years of age and shall have resided for a period of 30 days next preceding said election in the Territory of the Virgin Islands and in this election district for at least 30 days next preceding said election, that I am legally qualified to vote, that I have read (or have had read to me) the foregoing statements made in connection with my registration and that they are true and correct.

Name

Your name as it appears on your identification.

Title

First Name *

Middle

Last Name *

Suffix

Contact Information

Your physical and mailing addresses.

Email Address *

Phone Number *

Physical Address

Street No. *

Street Address *

Street Address 2

City *

State *

Postal Code *

Mailing Address

Is PO Box?

PO Box *

Box No. *

Street No. *

Street Address *

Street Address 2

City *

State *

Postal Code *

Personal Details

Last 4 of SSN *

Date of Birth *

Place of Birth *

Gender *

Hair Color *

Eye Color *

Political Party *

Document Type *

Document Number *

Documents

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