Change of Voter Registration Card
Elections System of the Virgin Islands Sunny Isle Shopping Center, Christiansted, St. Croix, V.I. (340) 773-1021 Lockhart Gardens, 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 New Party Affiliation (please check on …
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Elections System of the Virgin Islands Sunny Isle Shopping Center, Christiansted, St. Croix, V.I. (340) 773-1021 Lockhart Gardens, 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 New Party Affiliation (please check one) : ____Democrat ____Republican ____ICM ____ Independent 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 _________________ 20_____. ______________________________ Notary Public ELECTION SYSTEMS OF THE VIRGIN ISLANDS FORM 0016/98 SIGN