APPLICATION FOR CERTIFICATION 
AS AN 
ELIGIBLE VIRGIN ISLANDS SUPPLIER 
THIS APPLICATION MUST BE FILED IN ONE (I) 
ORIGINAL AND TWO (2) COPIES TO 
THE ECONOMIC DEVELOPMENT COMMISSION 
P.O. BOX 305038 
ST. THOMAS, VIRGIN ISLANDS 00803 
APPLICATION FOR CERTIFICATION AS AN ELIGIBLE SUPPLIER 
This application must be submitted with one (I) original and two (2) copies to the Ofice of 
the Director of Compliance, Economic Development Commission, P.O. Box 305038, St. 
Thomas, U.S.V.I. Telephone (340) 774-8 104. 
Name of Applicant 
Tax ID# 
Phone No. 
Fax # 
E-mail 
Mailing Address 
Plant Location 
Type of Business (Corporation, Partnership, Etc) 
Date organized in the Virgin Islands 
Name of Local Attorney or Representative 
Name and Address of Stockholders or Partners: 
Indicate date applicant began operating in the Virgin Islands 
Please submit the following: 
Name 
(A) Letter of clearance fiom the Virgin Islands Bureau of Internal 
Revenue indicating status of all Virgin Islands Tax obligations: copy of 
8832 classification election (LLC) 
(B) Copy of the Certificate of Good Standing (corporations), or Certificate 
of existence (LLC), Partnership Agreement (LLP, LLLP); and trade name 
certificate 
Physical Address 
(C) Copy of license to do business in the Virgin Islands 
% Owned 
@) Copy of latest audited financial statements, or Income Tax return 
(E) Stock Certificate and/or Proof of % ownership 
10. Description of product to be supplied, service or manufacturing process to be 
performed by applicant in the Virgin Islands: 
I I. Applicant agrees to inform the Economic Development Commission of any 
changes of ownership in the businms of the applicant within 30 days after 
such change or changes. 
DETERMINATION OF ELIGIBILITY OF SUPPLIERS FOR PURPOSE 
OF THE LOCAL PREFERENCE PROVISION; TITLE 29, SECTION 708 (h) 
VIRGIN ISLANDS CODE 
Section 708-7 1 1 of the Rules and Regulations of the Industrial Development 
Commission provides, in part, that: 
The Director shall certify in writing that a supplier is an Eligible Virgin 
Islands supplier. The Director shall make said certification, upon the request of a 
supplier, only after he is satisfied that the supplier meets all of the following 
criteria: 
( 1) 
As of the date of the certification, the supplier has been licensed to do 
business in the Virgin Islands for at least one year and has actually 
conducted business in the Virgin Islands for at least one year. 
(2) The supplier physically maintains its principal place of b,uisiness within 
the Virgin Islands and maintains an inventory in the Virgin Islands 
appropriates to the size of its business. 
(3) (A) 
In the case of an individual, the supplier must be a resident 
of the Virgin Islands. 
(B) 
In the case of a firm, partnership, LLP or LLLP, each member 
must be a resident of the Virgin Islands (if such member is an 
individual) or the member must meet the requirements of the 
immediately following sub-paragraph (if such member is a 
corporation). 
(C) 
In the case of a corporation or LLC, over 50% of the voting 
stock or equitable ownership must be owned by residents of 
the Virgin Islands, and the corporation must be incorporated 
in the Virgin Islands. 
(4) The supplier is in compliance with all Virgin Islands laws, including 
tax laws. 
The Director may require of the supplier such documentation as the Director d
m
 
necessary to determine that the supplier meets the above criteria. 
Economic Development Commission 
CERTIFICATIONS 
"UNDER THE PENALTIES AND PAINS OF PERJURY I HEREBY CERTIFY THAT 
ALL THE ABOVE INFORMATION, AS WELL AS ANY ACCOMPANYING 
DOCUMENT, ARE TRUE AND COMPLETE TO THE BEST OF MY 
KNOWLEDGE, INFORMATION, AND BELIEF" 
Company Name: 
Authorized Signature: 
Date: 
Name & Title 
(print or type) 
Reviewed By: 
Certified By: 
Title: 
Date: 
Date: 
SIGN