Election System of the Virgin Islands 
Sunny Isle Shopping Center, Christiansted, St. Croix, V.I. (340) 773-1021 
Crystal Gade, St. Thomas, V.I. (340) 774-3107 
 
P.O. Box 1499  Kingshill  St. Croix  U.S. Virgin Islands 00851 / P.O. Box 6038  St. Thomas  U. S. Virgin Islands 00801 
 
 
AFFIDAVIT 
 
Pursuant Title 18 section 116(c) of the Election Laws of the Virgin Islands 
 
TERRITORY OF THE VIRGIN ISLANDS  
  
District of St.______________________ 
 
 
I ______________________________________ DO HEREBY SWEAR AND AFFIRM: 
 
That I reside at_________________________________ in the district of ___________; 
 
That I possess all the qualifications of an elector and maintain a domicile in the U.S. 
Virgin Islands. 
 
That  I understand this  affidavit  its contents and that the facts therein are true and 
correct. 
 
I hereby subscribe to the truth of the statement herein contained, and to my oath or 
affirmation by the marking of my signature. 
 
 
__________________________ 
 
Witness  
 
_______________________ 
 
 
Subscribed and sworn to before note by the said______________________________ 
on this ___________day of________________ 2000 by the making in the presence of 
the witness hereto so swearing. 
_______________________ 
Notary Public 
 
 
 
ELECTION SYSTEMS OF THE VIRGIN ISLANDS FORM 0010/98