APPLICANT INFORMATION 
First: 
Middle: 
Last: 
Date of Birth:  
SSN: 
Phone#:  
Weight: 
Eye Color: 
Hair Color:  
Height: 
Blood Type: 
Gender:  
Male:  
Female: 
X: 
Place of Birth:     
Do you own/share ownership | have previously owned/shared 
ownership of a vehicle in the US. Virgin Islands?    Yes:   
 No:   
VIN #:  
Allergies:       
Is Veteran 
Yes: 
No: 
Is Organ Donor 
Yes: 
No: 
Has Glasses 
Yes: 
No: 
CURRENT ADDRESS 
Residence Address - Street:  
City: 
State: 
ZIP Code: 
Mailing Address:  
City: 
State: 
ZIP Code: 
Email Address: 
DRIVER’S LICENSE INFORMATION & RENEWAL | TRANSFER 
Current License #: 
Place & Date Issued: 
Expiration Date: 
Class of License: 
Driving Restrictions: 
Motorcycle:   
     Heavy Equipment:    
  School Bus: 
DISCLAIMERS 
WARNING 
UNDER TITLE 20, SECTION 548 VIC, IT IS IN VIOLATION “TO USE FALSE OR FICTITIOUS NAMES ON ANY APPLICATION FOR A 
DRIVER’S LICENSE OR IDENTIFICATION CARD, OR KNOWINGLY TO MAKE FALSE STATEMENT, KNOWNINGLY TO CONCEAL A 
MATERIAL FACT OR OTHERWISE COMMIT A FRAUD IN ANY SUCH APPLICATION.” 
MILITARY DRAFT REGISTRATION 
 
“BY SUBMITTING THIS APPLICATION, I AM CONSENTING TO REGISTRATION WITH THE SELECTIVE SERVICE SYSTEM, 
IF SO REQUIRED BY FEDERAL LAW. IF UNDER (18) YEARS OF AGE, I UNDERSTAND THAT I WILL BE REGISTERED AS 
REQUIRED BY FEDERAL LAW WHEN I ATTAIN EIGHTEEN (18) YEARS OF AGE.” 
Signature of Applicant: 
Date:  
All documents from foreign countries must be translated in English and notarized by a translator or have an official 
stamp/seal from the issuing country. For the Limited Purpose DL, a Criminal Record Check is required. 
PLEASE READ THE INFORMATION ON THE BACK OF THIS FORM 
GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES OFFICE OF THE GOVERNOR 
BUREAU OF MOTOR VEHICLES 
Limited Purpose DRIVER’S LICENSE Application 
Act 8790 
Proof of 180 Days (or more) of Residency Required 
For appointments and more information go to the Website: https://bmv.vi.gov/ 
Or Contact your local BMV office: St. Croix (340) 713-4268 |St. Thomas (340) 774-4268 |St. John (340) 776-6262 
| Find us on Facebook: www.facebook.com/BMV.USVI/ 
{Please Complete All sections of the Form} 
 
USVI Limited 
Purpose DL 
Primary 
Secondary 
IDENTIFICATION 
 
One (1) is required 
from Primary. 
or 
Two (2) 
documents are 
required from 
Secondary; one 
must be an ID 
with a photo. 
o Valid, unexpired passport 
issued by the applicant’s 
country of citizenship, or 
expired passport up to 2-years 
prior to application date. 
  
o Work Authorization permit 
card with I-797 or other 
immigration correspondence  
o Valid, unexpired motor vehicle operator’s license, with 
security features, issued by another state or country. 
o Valid national identification card. 
o  Original birth certificate with a raised seal issued by the 
applicant’s country. 
o Individual Taxpayer Identification Number from the IRB 
o Verifiable W-2 or 1099 
o Social Security Card 
o SSA 1099 
o Non SSA 1099 
o DD 214 
o Stamped IRB Income Tax Return 
o Voter’s Identification Card 
o Senior Identification Card 
 
SOCIAL 
SECURITY 
VERIFICATION 
 
No Social Security verification is 
required for Limited Purpose DL 
CURRENT 
RESIDENTIAL 
ADDRESS 
 
In order to 
qualify you 
must show 
Proof of 
Residency of 
180 Days or 
more 
 
 
 
Limited Purpose 
DL, one (1) is 
required from 
Primary.  
or 
Two (2) 
documents from 
different sources 
are required from 
Secondary.  
 
 
o Deed, Mortgage 
Payment/Booklet, or 
Notarized Rental Agreement 
o Utility Bill Showing the 
Physical Address 
o Homeowners Insurance 
Statement 
o  Notarized Statement from 
Person with Whom the 
Applicant Resides, along with  
o One (1) Address Document 
Listed above, which is in that 
Person’s Name. 
 
Vehicle Insurance Card is NOT 
Accepted. 
 
o Dated utility or medical bill. 
o Dated bank or credit card statement or transaction, 
including the bank’s name and mailing address. 
o Pre-printed pay stub 
o IRB stamped tax bill dated not less than twelve before the 
date of application. 
o A current homeowner’s insurance or renter’s insurance 
policy or motor vehicle insurance card or policy 
o Residential contracts such as a mortgage or lease showing 
signatures from all parties needed to execute the 
agreement dated not less than twelve months before the 
application. 
o Postmarked mail from the government or a utility company 
dated not less than twelve months before the application. 
o A change of address confirmation from the United States 
Postal Service indicating an applicant’s current and prior 
address 
o A survey of an applicant’s real property issued by a licensed 
surveyor. 
o An official school record showing enrollment, dated up to 
12 twelve months prior to application date. 
o Notarized affidavit from two persons attesting proof of 
residency 
o Vehicle Certificate of Title or Vehicle Registration 
FOR DL CONVERSION ONLY:  Valid & unexpired License, complete Certified Medical Form & Written Exam, Driving 
verification/history from issuing country in English. 
US. VIRGIN ISLANDS LIMITED PURPOSE DRIVER’S LICENSE REQUIRED DOCUMENTS 
FOR APPLICANTS WITH NO DL:  Complete Certified Medical Form, Written Exam, Road Test.