For Zoning Cases Only
By submitting this form, you are attesting to the validity of this report and acknowledge your willingness to appear in court as a witness against the alleged violator of the Loudoun County Zoning Ordinance. Please be advised that you will be contacted by telephone to verify the information contained on this form prior to the allegations being investigated, so please provide a valid daytime contact number.

In order to request to keep your name confidential with respect to requests from the public for release of information in accordance with the Freedom of Information Act, please explicitly state this request in the “details” section of the complaint form.

Agreement
By completing the Citizen Service Request Form, I acknowledge that I have read, understood, and agree to the information above.

Should you require further assistance with completion of this form, please contact the citizen relations manager in the Office of the County Administrator at 703-777-0200.