GOVERNMENT OF 
THE UNITED STATES VIRGIN ISLANDS 
OFFICE OF THE LIEUTENANT GOVERNOR 
 DIVISION OF REAL PROPERTY TAX 
1105 King Street • Christiansted, Virgin Islands 00820 • 340-773-6449 •  
5049 Kongens Gade • Charlotte Amalie, Virgin Islands 00802 • 340-774-2991 •  
Apply to Parcel #:  
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Signature:  
 
Apply to Other:
SINGLE-USE CREDIT CARD AUTHORIZATION FOR PAYMENT PLANS
Please print, sign and return this authorization form to our office by the following methods: 
By Fax to any District:(340) 776-5039
By Email to any District: paymentplans@lgo.vi.gov,  
By Postal Mail: Office of the Tax Collector   5049 Kongens Gade  Charlotte Amalie, VI 00802 
______________________________________________________________________________ 
* Check this Box if this payment is for an Installment Payment Agreement (IPA):
Date: _____________________ 
Cardholder Name:  ___________________________________________________ 
Credit Card Type:  
        VISA                 MASTERCARD               ATM/ATH CARD 
Credit Card Number: ________________________________________________________ 
Expiration Date:          ____________________  
Card ID Number (3 digits located on the back of the credit card):  ___________ 
Billing Address:    _____________________________________________________ 
        _____________________________________________________ 
        _____________________________________________________ 
Contact Number :  ______________________  Email: ________________________ 
Amount to be Charged: (USD)$________________ 
SIGN