Government of the Virgin Islands 
of the United States 
Department of Licensing and Consumer Affairs 
 
 
 
 
 
 Golden Rock Shopping Center   
Administrative Complex               
Property & Procurement Building 
 3000 Estate Golden Rock, Suite 9 
“The Battery” 
 
    
8201 Subbase, Suite 1 
 St. Croix, VI  00820-4311 
 
St. John, VI  00830 
 
       
St. Thomas, VI  00802-5826 
 Telephone: 340.713.3522   
                          Telephone: 340.693.8036 
       
                          Telephone: 340.714.3522 
 Facsimile: 340.718.6982  
 
                          Facsimile: 340.776.6989 
       
                          Facsimile: 340.776.8303  
 
OFFICE OF THE COMMISSIONER 
Virgin Islands Board of Control of Alcoholic Beverages  
              Alcohol Release Form 
 
__________  
 
 
 
 
 
____________________ 
Date 
 
 
 
 
 
 
 
Bill of Lading No. 
 
 
 
 
Permission is hereby granted to Consignee _____________________________________________for  
 
 
 
 
 
              (Business Name) 
 
removal of_______________________________ alcoholic beverages arriving in St. Croix/St.Thomas  
 
(No. of cases) 
 
United States Virgin Islands from _________________________________________________ on 
 
 
 
 
 
 
(Name of shipper) 
 
 _______________________ on the ____________________________________________________ 
         (Date) 
 
 
 
 
 (Name of Carrier) 
 
 to his/her warehouse located at ______________________________________________________  
 
 
 
(Business address) 
 
 
 
 
No item of this shipment shall in any way be removed from its container or distributed prior to proper 
certification of conformation with Virgin Islands Rules and Regulations§2-41 covering import of alcoholic 
beverages and release by the Bureau of Customs.  
 
Failure to comply with the above instructions would subject the Consignee to legal action under the said 
Virgin Islands Rules and Regulations.  
 
 
 
 
 
 
 
_____________________________ 
 
 
 
 
 
 
 
Authorizing Officer signature 
 
_____________________________ 
RELEASE 
 
This shipment conforms with the Virgin Islands Rules and Regulations covering imports of Alcoholic 
Beverages. 
 
______________________________ 
 
 
 
__________________________ 
                     Print 
 
 
       
 
 
                      Title 
 
 
 
 
 
 
 
 
___________________________ 
Date