Government of 
The United States Virgin Islands 
-0-
VIRGIN ISLANDS POLICE DEPARTMENT 
ALEXANDER A. FARRELLY 
JUSTICE CENTER 
CHARLOTTE AMALIE 
ST. THOMAS, V.I. 00802 
(340) 774-2310 
LEANDER JURGEN 
COMMAND 
CRUZ BAY 
ST. JOHN, V.I. 00830 
(340) 693-8880
POLICE OPERATIONS AND 
ADMINISTRATIVE SERVICES 
# 45 MARS HILL, 
FREDERIKSTED 
ST. CROIX, V.I. 00841 
POLICE PERMIT FORM 
TYPE OF SERVICE REQUESTED 
□Police Escort:  □ Police Presence  □  Police Permission  □  Road Blockage  □  Blanket Permit  □  Parking Permit
□Liquor Permit
Contact Person:  ______________________________________________________ 
Company or Organization:  _____________________________________________
Tel. Number:  __________________________________________________________ 
Location: _______________________________________________________________
Time of Event:  Begin:  __________ End:  _________   Date of Event: ____________ 
Type of Event:   
Police Escort: 
Escort Begins at  __________________________  Ends:  __________________________________ 
Will there be an event at the completion of the escort?  Yes  □  No:  □    Dimensions: ______________________________________________
If Yes, will you need police presence or permission?  Yes  □  No:  □                            ______________________________________________
Police Presence: 
Police Presence needed at:  _________________________________________________ 
Number of Attendees:  _____________________________________________________ 
Police Permission: 
Type of Event:  _____________________________________________________________ 
Road Blockage: 
Name of Road to be Blocked off:  ________________________________________________ 
Exact Location: (City/Neighborhood)  ______________________________________________ 
Parking Permit 
Name of Company: ____________________________________________________________ 
Reason for Parking Permit:  _____________________________________________________ 
Other Information:  ___________________________________________________________ 
Liquor Permit
Reason for Permit: ___________________________________________________
** A fee will be charged for each rendered service.  We are not authorized to waive fees.** 
** Final Payments for permits are non-refundable**. 
VIPD-PPF-2022          Email Form to vipdchiefoffice-stx@vi.gov (STX); vipdchiefoffice-stt@vi.gov (STT)
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HN
Barricade Rental
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