Election System of the Virgin Islands 
Sunny Isle Shopping Center, Christiansted, St. Croix, V.I. (340) 773-1021 
Crystal Gade, St. Thomas, V.I. (340) 774-3107 
 
P.O. Box 1499  Kingshill  St. Croix  U.S. Virgin Islands 00851 / P.O. Box 6038  St. Thomas  U. S. Virgin Islands 00801 
 
CHANGE OF VOTER REGISTRATION CARD / STATUS 
 
 
TERRITORY OF THE VIRGIN ISLANDS 
 
DISTRICT OF ____________________ 
 
 
 
I, _____________________________________ HEREBY REQUEST A CHANGE OF MY VOTER 
REGISTRATION CARD / STATUS. 
  
TYPE OF CHANGE (Please check below) 
 
Change of name 
 
Change of Party / Membership Request 
 
Change of Address Physical or Mailing 
 
Other 
 
NAME CHANGE 
Present Name on registration card: _________________________________________ 
New name to be recorded: ________________________________________________ 
Legal documents proof of change: __________________________________________ 
 
PARTY AFFILIATION 
Present party affiliation (please check one): __Democrat __Republican __ICM __Independent __Other 
 
New Party affiliation (please check one): __Democrat __Republican __ICM __Independent __Other 
 
ADDRESS 
Present Address: ________________________________________________________ 
Previous Address:_______________________________________________________ 
Present Mailing Address: __________________________________________________ 
Previous Mailing Address: _________________________________________________ 
 
_______________________  
 
 
__________________________ 
Date 
 
 
 
 
 
 
 
Signature of Elector 
 
OFFICIAL USE ONLY 
Verified by: ____________________________________ 
Date:_________________ 
______________________________________________________________________ 
Election Officials 
 
 
SUBSCRIBED 
AND 
SWORN 
to 
before 
me 
on 
this 
___________day 
of________________ 19____ .  
 
_______________________ 
Notary Public 
 
ELECTION SYSTEMS OF THE VIRGIN ISLANDS FORM 0015/98