GOVERNMENT OF THE VIRGIN ISLANDS  
OF THE UNITED STATES  
OFFICE OF THE GOVERNOR  
BUREAU OF MOTOR VEHICLES  
BMV FORM NO. (2019-08) – REV. Jun. 24-2020 
CONSENT AND ASSUMPTION 
OF  
FINANCIAL RESPONSIBILITY 
 
KNOW ALL MEN BY THESE PRESENT: 
I, ____________________________________ PURSUANT TO TITLE 20, 
SECTION 374, SUB-DIVISION OF THE VIRGIN ISLANDS CODE, BEING THE 
PARENT, GUARDIAN OR OTHER PERSON RESPONSIBLE FOR THE CARE, 
CUSTODY OR CONTROL OF _____________________________ A MINOR 
_________ YEARS OF AGE, HEREBY GIVE MY CONSENT TO THE VIRGIN 
ISLANDS BUREAU OF MOTOR VEHICLES FOR THE ISSUANCE TO THE SAID 
MINOR OF A LICENSE TO OPERATE AN AUTOMOBILE, IF THE MONOR IS 16, OR 
MORE YEARS OF AGE. I ALSO ASSUME FINANCIAL RESPONSIBILITY FOR 
DAMAGES RESULTING FROM ANY TORT COMMITTED BY THE AFORESAID 
MINOR ARISING FROM HIS OR HER OPERATION OF A MOTOR VEHICLE. THE 
CONSIDERATION FOR THIS ASSUMPTION OF LIABILITY IS THE ISSUANCE OF 
SAID LICENSE AND THE BENEFITS TO SAID MINOR WHICH MAY RESULT.  
 
I AUTHORIZE (IF APPLICABLE)                                                                   TO ACT ON 
MY BEHALF. 
 
RESIDENCE ADDRESS: _________________________________ 
 
    
 
         _________________________________ 
PARENT/GUARDIAN 
SIGNATURE:                    _________________________________ 
 
SWORN AND SUBSCRIBED TO BEFORE ME AS TRUE AND CORRECT, THIS 
 
__________ DAY OF _______, _________ 
 
NOTARY PUBLIC: ________________________