GOVERNMENT
GOVERNMENT
GOVERNMENT
GOVERNMENT OF THE 
OF THE 
OF THE 
OF THE VIRGIN ISLANDS 
VIRGIN ISLANDS 
VIRGIN ISLANDS 
VIRGIN ISLANDS  
OF THE UNITED STATES 
OF THE UNITED STATES 
OF THE UNITED STATES 
OF THE UNITED STATES  
OFFICE OF THE 
OFFICE OF THE 
OFFICE OF THE 
OFFICE OF THE GOVERNOR
GOVERNOR
GOVERNOR
GOVERNOR  
BUREAU OF MOTOR VEHICLES 
BUREAU OF MOTOR VEHICLES 
BUREAU OF MOTOR VEHICLES 
BUREAU OF MOTOR VEHICLES  
BMV FORM NO. (2019-08) – REV. Apr. 2-2019 
CONSENT AND ASSUMPION 
OF  
FINANCIAL RESPONSIBILITY 
 
KNOW ALL MEN BY THESE PRESENT: 
I, ____________________________________ PURSUANT TO TITLE 20, 
SECTION 374, SUB-DIVISION OF THE VIRGIN ISLANDS CODE, BEING THE 
PARENT, GUARDIAN OR OTHER PERSON RESPONSIBLE FOR THE CARE, 
CUSTODY OR CONTROL OF _____________________________ A MINOR 
_________ YEARS OF AGE, HEREBY GIVE MY CONSENT TO THE VIRGIN 
ISLANDS BUREAU OF MOTOR VEHICLES FOR THE ISSUANCE TO THE SAID 
MINOR OF A LICENSE TO OPERATE AN AUTOMOBILE, IF THE MONOR IS 16, OR 
MORE YEARS OF AGE. I ALSO ASSUME FINANCIAL RESPONSIBILITY FOR 
DAMAGES RESULTING FROM ANY TORT COMMITTED BY THE AFORESAID 
MINOR ARISING FROM HIS OR HER OPERATION OF A MOTOR VEHICLE. THE 
CONSIDERATION FOR THIS ASSUMPTION OF LIABILITY IS THE ISSUANCE OF 
SAID LICENSE AND THE BENEFITS TO SAID MINOR WHICH MAY RESULT.  
 
 
RESIDENCE ADDRESS: _________________________________ 
 
    
 
         _________________________________ 
PARENT/GUARDIAN 
SIGNATURE:                    _________________________________ 
 
SWORN AND SUBSCRIBED TO BEFORE ME AS TRUE AND CORRECT, THIS 
 
__________ DAY OF _______, _________ 
 
NOTARY PUBLIC: ________________________ 
SIGN
SIGN