2026 ETHICAL REPORTING FORM

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Use this form to:

1. Disclose all conflicts of interest YOU may have as an employee of the Government of the Virgin Islands (GVI).

2. Report any alleged GVI ethical violation(s) as outlined in Executive Order 540-2025.

The information disclosed in this form shall be considered confidential and may only be released on a need-to-know basis.

The following DO NOT fall under this ethics reporting system and should reported to your Human Resources Office or the approprite reporting agency:

Workplace disputes
Performance or supervision issues
Interpersonal conflicts
Leave/timekeeping disagreements
Harassment/discrimination
Union-related grievances

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Please select an option to report:* This field is required.

Disclose Possible Conflict(s) of InterestReport Alleged Ethical Violation(s)

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Do you wish to remain anonymous?* This field is required.

YESNO

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Your Name* This field is required.

First Name

Last Name

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Your Email* This field is required.

example@example.com

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AEV-Select the department(s) where the alleged Ethical violation(s) occurred.* This field is required.

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AEV-Name the individual(s) involved in the alleged ethical violation(s):* This field is required.Use "last name, first name - position" format and click "add row" for each additional entry.

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AEV-To your knowledge, how many times has the alleged violation(s) occurred?* This field is required.

Once

More than once

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AEV-Approximately when did the alleged ethical violation(s) occur?* This field is required.Indicate date(s) using MM/DD/YYYY format.

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AEV-Describe the nature of the ethical violation(s).* This field is required.Be as detailed as possible.

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AEV-Upload attachments, if any, that may support your claim:

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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AEV-Have you reported the alleged ethical violation(s) in the past?* This field is required.

YESNO

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AEV-Alleged Ethical Violations Previous Report Details:* This field is required.

First and Last Name of the person to whom you reported the alleged violation(s).

Approximate date(s) when you reported the alleged violation(s).

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This section is intended for employees who wish to report thier own conflict of interest in performing their duties at a GVI Employee.

A Conflict of Interest arises when an individual’s personal interests, relationships, or activities have the potential to interfere with their official duties, decisions, or responsibilities.

If you do not wish to disclose your conflict of interest and wish to report a conflict of interest for another employee, please click previous and select the Report Alleged Ethical Violation Option.

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Your Position* This field is required.

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Select your agency* This field is required.

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CI-Describe in detail any relationships (familial or otherwise), transactions, positions you hold (volunteer or otherwise), and/or circumstances that you believe could contribute to a conflict of interest. * This field is required.

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CI-Do you have an additional conflict to disclose?* This field is required.

YESNO

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CI-Describe in detail any relationships (familial or otherwise), transactions, positions you hold (volunteer or otherwise), and/or circumstances that you believe could contribute to a conflict of interest.* This field is required.

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CI-Do you have an additional conflict to disclose?

YESNO

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CI-Describe in detail any relationships (familial or otherwise), transactions, positions you hold (volunteer or otherwise), and/or circumstances that you believe could contribute to a conflict of interest.* This field is required.

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CI-Do you have an additional conflict to disclose?

YESNO

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CI-Describe in detail any relationships (familial or otherwise), transactions, positions you hold (volunteer or otherwise), and/or circumstances that you believe could contribute to a conflict of interest.* This field is required.

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AEV-The information I have provided in this form is true, complete, and accurate to the best of my knowledge and belief and relates to conduct covered by the GVI Ethical Code of Conduct.* This field is required.

Yes, I attest to the statements above.

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CI-The information I have provided in this form is true, complete, and accurate to the best of my knowledge and belief. Should any additional conflict of interest arise as it relates to my employment in the GVI, I recognize I have a continuing obligation to submit a new Conflict of Interest Disclosure form.* This field is required.

Yes, I attest to the statements above.

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Based on the option selected, this matter is not within the jurisdiction of this ethical reporting system.

Please EXIT this form and direct the issue to your agency's Human Resources office or the appropriate reporting entity.