Submit a Claim - Claim Instructions

This Claim Form is for residents of St. Croix whose current residence was impacted by a release from the Limetree Bay Facility on February 4, 2021 or May 12, 2021 (the “Release Events”) and who believe they satisfy the following requirements to participate in the Court-ordered Limetree Water Distribution Program (the “Water Program”). Each Eligible Resident is entitled to up to twelve (12) gallons of water per day per household, with a maximum amount per household of eighty-four (84) gallons of water per week. To participate in the Water Program, you must complete and submit this Claim Form along with supporting documentation.

  1. You must attest AND support that you currently reside in one of the following estates (the “Covered Area”): Adventure, Betty’s Hope, Cane, Cain Carlton, Campo Rico, Carlton 1 North, Carlton 1 South, Carlton 2, Clifton Hill, Concordia, Diamond, Enfield Green, Envy, Frederiksted, Golden Grove, Good Hope, Hannah’s Rest, Hesselberg, Hogensborg, La Grange, Mannings Bay, Mount Pleasant, Negro Bay, Paradise, Ruans Bay, Sandy Point, Smithfield, Stony Ground, Two Brothers, Upper Bethlehem, Wheel of Fortune/Mars Hill, Whim, Whites Bay, Whites Bay 2, and Williams Delight; AND
  2. You must attest that your current residence actively uses or used cistern water; AND
  3. You must attest that you have a belief that your current residence was impacted by a Release Event; AND
  4. You must attest and support that you meet certain criteria showing you cannot afford to purchase water without trading off other basic necessities (“Financial Hardship”).

IMPORTANT: To be accepted, your Claim Form must be completed, signed, and dated. If your Claim Form is incomplete, unsigned, or contains inaccurate information, it will be rejected, and you will need to resubmit your Claim Form. Note, however, that your Claim Form may be signed via electronic signature.

The requirements must be satisfied by any adult applicant to participate in the Water Program, and if the requirements are satisfied as to any adult, then they are also deemed to have been satisfied by all other members of that person’s household residing at the same address (i.e., if an Applicant qualifies, then the household qualifies). For this reason, this Claim Form requests that the Applicant list all members of his or her household.


Documentation must be provided to support your Claim. Please review the table below to understand the type of documentation required to successfully prove your Claim.

Documentation Type Acceptable Documentation
Proof of Identification
  • Valid Driver’s License
  • Valid Government-Issued Identification
  • Other Validly-Issued Photo Identification
Proof of Occupancy
  • Current Lease
  • Mortgage or mortgage statement
  • Deed
  • Recent utility bill
  • Recent credit card statement
  • Other similar document showing you currently reside in the Covered Area
Proof of Financial Hardship
  • Program card confirming admission or participation
  • Email confirmation of admission
  • Internet website printout(s) confirming admission
  • Letters confirming admission
  • Financial document, such as bank statement, showing Program payments
  • Other similar documents evidencing admission
  • Evidence you would be eligible to qualify for a Listed Program
Optional Home Delivery
  • Doctor or Hospital Note requesting that water be delivered to your residence

If you are filing online, you will be prompted to upload your documentation. Please have this information ready before you start to file. Documents that are uploaded with an online claim must be less than 20MB per file and in one of these formats: jpg, jpeg, png, gif, tif, tiff, doc, docx, xls, xlsx, pdf, txt, rtf, or zip.

If you are mailing or emailing your Claim Form, you must include clear, readable copies of the relevant documentation. Do not send us any originals, as we will be unable to return it to you.

How to File Online:

You can complete and submit the Claim Form and supporting documentation online. Please ensure you have your documentation ready before you begin filing.

Please click the button below to get started.

How to File by Mail or Email:

You can complete and submit this Claim Form and supporting documentation by mailing it to the following address for the Limetree Water Program Administrator:

Limetree Water Distribution Program Administrator
P.O. Box 2257
Portland, OR 97208-2257


You can email the completed Claim Form and supporting documentation to the following email address:

How to File at a St. Croix Law Office:

You can complete and submit the Claim Form and supporting documentation at one of the following law offices located on St. Croix during regular business hours:

Lee J. Rohn & Associates
56 King Street
Third Floor
Hamilton House
Christiansted, U.S.V.I
Colianni and Leonard
2120 Company Street
Christiansted, St. Croix
Dema Law
1236 Strand Street
Suite 103
Christiansted, St. Croix

How to File at a Water Distribution Center:

You can submit a Claim Form and supporting documentation at any of the following Grocery Stores:

  1. Stop and Shop, located at 52 Hannah’s Rest #D, Frederiksted, 00840;
  2. The Market, located at 14 Plessen, Frederiksted, 00840; and
  3. Plaza Extra East, located at 4200 United Shopping Plaza, 00820.

All locations are open from 8:00 a.m. to 8:00 p.m., Monday through Saturday, except for Federal holidays or days when a particular participating grocery store is closed to the public.