Financial Disclosure Forms

Members of certain boards, authorities, commissions, or committees ("BACs") must file financial disclosure statements upon appointment, and annually thereafter. Effective January 1, 2006, new appointees must file the form with the Clerk’s Office before voting as an official member. See updated list below of BACs required to file effective January 1, 2006.  

In addition to the the financial disclosures, members need to review and potentially submit Virginia Freedom of Information Act (VFOIA) documents.  There are two VFOIA documents.  Package A references the VFOIA and Public Records Act and includes the Conflict of Interests Act. Package B only references the VFOIA and Public Records Act.

These forms are from the Commonwealth of Virginia and are available in PDF.  Completed forms can be sent to the Clerk’s Office by email (scan and send to, fax (703-324-3926), or US mail (12000 Government Center Parkway, Suite 533, Fairfax, VA 22035).  For further information, visit the Office of the Secretary of the Commonwealth at

To view the document, you will need to have Adobe Acrobat Reader installed on your computer. Click below to obtain a free copy.


Disclosure Forms

Financial Cover

Financial Disclosure Statement (PDF 81 kb):
[short form]

Members of the following BACs must file this form:

  • Animal Services Advisory Commission
  • Board of Building Code Appeals
  • Board of Equalization
  • Chesapeake Bay Preservation Ordinance Exception Review Committee
  • Civil Service Commission
  • Fairfax County Convention and Visitors Corporation Board
  • Fairfax-Falls Church Community Services Board
  • Geotechnical Review Board
  • History Commission
  • McLean Community Center
  • Reston Community Center
  • Upper Occoquan Sewage Authority
  • Wetlands Board

Statement Cover

Statement of Economic Interests (PDF 81 kb):
[long form]

Members of the following BACs must file this form instead of the short form:

  • Board of Zoning Appeals
  • Economic Development Authority
  • Employees' Retirement System Board of Trustees
  • Industrial Development Authority
  • Library Board
  • Park Authority
  • Planning Commission
  • Police Officers Retirement Board
  • Redevelopment & Housing Authority
  • Uniformed Retirement Board
  • Water Authority

(NOTE: Members of the Board of Supervisors and certain County staff members also file this form.)


Real Estate Cover

Real Estate Holdings  (PDF 45 kb):

In addition to filing the long form, members of the following BACs must file this form:

  • Board of Zoning Appeals
  • Planning Commission

(NOTE: Certain staff in the Department of Tax Administration also file this form.)


The Virginia Freedom of Information Act (VFOIA) and the Virginia Public Record Act Documents

There are two packages of information that should be read and reviewed:

  • Package A which includes the Virginia Conflict of Interests Act (110 pages - 1.3MB)
  • Package B only the VFOIA and Public Records Act (68 pages - 866KB)


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