Retro-Retiree reimbursement: Employee Inquiry Form

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Welcome GVI employees. This form is for retired government employees over the age of 65, who are owed retroactive wages and their name did not appear on the Retiree Compensation portal on the Division of Personnels webiste (https://www.dopusvi.org/comp2021).

Please be prepared to upload any documentation showing that you are owed retroactive wages and a form Government issued identification.
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Employee Name* This field is required.
First Name
Middle Name
Last Name
3
Employee Mailing Address* This field is required.
Street Address
Street Address Line 2
City
State
Zip Code
4
Are you a retired government employee 65 or older* This field is required.You must be a retired government employee who is age 65 or older.
YESNO
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Employee Date of Birth* This field is required.You must be a retired government employee who is age 65 or older.
Date
Month
Day
Year
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Last 4 digits of Employee Social Security Number* This field is required.
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Employee ID Number* This field is required.
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Employee Phone Number* This field is required.
Area Code
Phone Number
9
Email* This field is required.
example@example.com
Confirm Email
10
Did you receive a retroactive payment in 2010?* This field is required.
YESNO
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If possible, please upload any documentation showing that you are owed retroactive wages.These documents should be copies of payments you received in 2010 or documents that show outstanding balances owed to you.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Please upload your government Issued ID* This field is required.Passport, Drivers License or Voters Registration card
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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