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Robert S. Wertz, Jr. Web loudoun.gov/COR Phone [PHONE REDACTED] Mailing Address PO Box 8000 Leesburg, VA 20177-9804 In-person Service Leesburg - 1 Harrison Street SE, 1st Floor Sterling - 46000 Center Oak Plaza Alleged Tax Evasion Report General Information Businesses and individuals must comply with tax requirements. If you have information about potentially untaxed or undertaxed real estate, vehicles, business property, or activity, you can promote fair taxation by sharing your concerns. Your report may lead to an inquiry. To report an alleged zoning violation, visit loudoun.gov/lex. Review relevant info at: loudoun.gov/Taxes. Use this form to to report your concerns regarding the tax compliance status of a person or entity within Loudoun County. Need help? Staff assistance is available Monday - Friday during business hours. If visiting in person, we encourage scheduling an appointment. Accommodations: If you require a reasonable accommodation for any type of disability or need language assistance in order to utilize this form, please email [EMAIL REDACTED]. Three business days advance notice is requested. Privacy: This Office protects records according to applicable Virginia statutes and U.S. federal laws. Any personal information we collect and maintain is retained in compliance with statute. We will maintain complainant's confidentiality unless subject to court order. Instructions Fill out each section of the form and sign the certification. Submit it in person or: • Upload it online: loudoun.gov/COR-Upload • Complete the webform: loudoun.gov/COR-Forms • Mail it to Business Tax Compliance PO Box 8000, Leesburg VA 20177-9804 Subject of Report (please provide as much information as you know) Business/Organization Name Street Address, City, Zip Owner/Manager Name Email Phone Business Website Alternate Contact Name Alternate Phone Describe Tax Concern (untaxed/undertaxed real estate, business property or activity) You may attach supporting documents. [ ] I have information about a vehicle Make Model Color Vehicle Location (address where vehicle is typically parked and dates and times observed) License Plate (State & Number) Vehicle Distinguishing Characteristics & Concerns (example: ladder racks; business use vehicle receiving tax relief) Complainant Contact Information (allows us to follow up if we have questions) Name Phone Email Mailing Address 1 I BTC4-0525