OFFICE USE ONLY  •  Date received: __________  Received by: _________________________  Receipt no.: __________ 
 
OFFICE OF THE LIEUTENANT GOVERNOR 
NOTARIES PUBLIC DIVISION 
5049 Kongens Gade • St. Thomas, Virgin Islands 00802   (340)774-2991 
                                                  REQUEST FORM 
APOSTILLE OR CERTIFICATE OF AUTHENTICATION 
STANDARD FEE                  
$25.00 per document 
STANDARD SERVICE          
7–14 business days 
RUSH SERVICE  •  Add $50.00 
VIRGIN ISLANDS  Residents Only 
 Transactions or mailings that extend beyond the 
Virgin Islands are not eligible for rush processing. 
A copy of the applicant’s valid photo identification must accompany this request. 
1  APPLICANT INFORMATION 
First name 
______________________________
______________________________ 
Last name 
____________________________
____________________________ 
Date 
_______________________________
_______________________________ 
Mailing address 
______________________________
______________________________ 
City / State / ZIP 
____________________________
____________________________ 
Daytime telephone 
_______________________________
_______________________________ 
Email address 
 
______________________________ 
Firm or organization                        
(if applicable) 
____________________________
____________________________ 
Person picking up document(s)          
(Other than client) 
_______________________________
_______________________________ 
2  DOCUMENT AND SERVICE DETAILS 
Name(s) listed on the document 
_____________________________________ 
 
Service requested  ☐  Apostille  ☐  Certificate of Authentication      
☐  Notary Verification 
Type of document 
_____________________________________ 
The country where the document will be used 
_______________________________________________ 
3  PAYMENT                           Checks/money orders payable to the  
                                                    Government of the Virgin Islands 
 
Number of documents:  ________ 
×  $25.00 per document 
TOTAL:  $________________ 
☐  Money order no. 
__________________ 
☐  Check no. 
________________________ 
☐  Credit Card 
________________________ 
4  RETURN DELIVERY                                   Important: All mailing transactions require a tracking number 
☐  Self-addressed carrier label:   ☐ FedEx   ☐ UPS   ☐ DHL        Tracking no. __________________________ 
☐  Self-addressed USPS:   ☐ Priority Mail   ☐ Express Mail        Tracking no. __________________________ 
5  APPLICANT ACKNOWLEDGMENT 
I have reviewed the requested document(s) in their entirety and verified that the names and dates contained therein are 
accurate. 
____________________________ 
Printed Name 
____________________________ 
Signature 
____________________ 
Date