Mobile Notary Public Application 
Rev. 8/2023
      
 
 
 
 
 
  
                GOVERNMENT OF THE VIRGIN ISLANDS 
                             OF THE UNITED STATES 
              OFFICE OF THE LIEUTENANT GOVERNOR 
                                                             5049 Kongens Gade 
                                                                                        Charlotte Amalie, Virgin Islands 00802 
                                                                                                        1(340) 774-2991 
 
                MOBILE NOTARY PUBLIC APPLICATION       
 
PLEASE COMPLETE THIS APPLICATION IN ITS ENTIRETY.  LEAVE NO BLANKS. 
 
DATE 
  
 
 
NAME   
 
LEGAL LAST NAME 
LEGAL FIRST NAME                   MIDDLE INITIAL 
 
 
MAILING ADDRESS 
  
 
           P.O. BOX OR STREET                                                                                                      CITY, STATE, ZIP 
 
RESIDENTIAL ADDRESS  
 
              STREET ADDRESS, CITY, STATE, ZIP 
 
EMAIL ADDRESS____________________________________________________ 
 
CONTACT NUMBERS   
 
     HOME 
        MOBILE CELLULAR 
 
 
LOCATION OF MOBILE NOTARY BUSINESS ___________________________________ 
 
SERVICING WHICH AREAS ______________________________________________ 
 
BUSINESS PHONE_____________________________________________________ 
 
BUSINESS EMAIL______________________________________________________ 
 
MOBILE BUSINESS HOURS _______am _________pm  
 
MOBILE DAYS ___________ TO ________________ 
 
 
To become a mobile notary in the Virgin Islands, you must meet the same requirements     
as a commissioned notary. Complete the application and register before adding mobile 
notary services to your resume.