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 100(d) 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 or by continued residence in the district 
will have acquired such qualifications before the next ensuing election and I am therefore 
entitled to register; 
 
That I hereby allege inability to sign my name and do further allege that this inability is 
not due to physical infirmity; 
 
That I have been informed that I must present affidavits subscribed in person before a 
member of the board or clerk of two electors who are personally acquainted with me and 
know my qualifications as an elector before my registration nary be completed; 
 
That this affidavit beets read to me that I understand 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 mark. 
 
 
__________________________ 
 
Witness  
 
_______________________ 
 
 
Subscribed and sworn to before note by the said______________________________ 
on this ___________day of________________ 19____ by the making in the presence 
of the witness hereto so swearing. 
_______________________ 
Notary Public 
 
 
 
ELECTION SYSTEMS OF THE VIRGIN ISLANDS FORM 0010/98