Economic Development Bank - Affidavit of Eligibility (Micro-Loan) Form                                                       Rev  9/2015 
 
 
                                          AFFIDAVIT OF ELIGIBILITY 
 
 
United States Virgin Islands                           ) 
District  of ___________________________________) ss: 
 
 I, ____________________________________________________, being first duly sworn depose and say:  
                                    (Name)                                              
 
1. I make this affidavit for the purpose in inducing the Government Development 
Bank/Small Business Development Agency to grant a loan and/or other assistance to 
_____________________________________________________ herein known as the “applicant.”  
                                        (Name of Concern)  
 
2. I own at least 50% legal or equitable interest in applicant. 
 
3. I do not hold such interest in trust for any other person. 
  
4. I am or will be active in the management or operation of the applicant’s business on a full-
time basis and such business is or will be my principal means of support. 
 
5. I am otherwise eligible as follows: 
  
[   ] I was born in the Virgin Islands. 
 
[   ] My Father (   ) and/or Mother (   ) was / were born in the Virgin Islands and I have 
been a bona fide continuous resident of the U.S. Virgin Islands for five (5) years or 
more. 
 
[   ] I have been a bona fide continuous resident of the U.S. Virgin Islands for Five (5) 
years or more. 
 
6. I understand that a false statement on this affidavit is punishable by a fine of $5000.00 
and imprisonment for five (5) years or such other penalty as may be provided by law. 
                                                                                    
Further affiant sayeth not. 
                    _____________________________________________ 
                                       (Signature of Affiant) 
Subscribed and sworn before me, a Notary Public,   
in and for the United States Virgin Islands on this 
_______ day of _____________________________,  20 _____. 
 
SIGN