Skip to main content
Fairfax County, Virginia
Fairfax County Virginia
Fairfax County Virginia

FFX Global Navigation

    • HHS Homepage
    • About HHS
    • HHS Strategic Allocation of Resources (StAR)
    • 3 to Succeed
    • Eviction Prevention
    • Extreme Heat Resources
    • Successful Children and Youth Policy Team (SCYPT)
    • Vulnerability Index
  • Residents
    • Animals & Pets
      • Adoptions
      • Animal Control & Regulations
      • Guide to Dogs
      • Lost & Found Pets
      • Shelter Support & Supplies
      • Wildlife
      • More
      Courts & Legal
      • Case Information
      • Circuit Court Docket
      • Jury Duty
      • Land Records
      • Magistrate
      • Public Law Library
      • Self-Help Resources
      • Traffic Court
      • Vital Records
      • More
      Environment & Energy
      • Invasive Species
      • Litter
      • Recycle, Trash & Compost
      • Sustain Fairfax
      • Trees
      • Watersheds
      • More
      Health & Human Services
      • Basic Needs & Assistance
      • Disability Services
      • Diseases & Conditions
      • Domestic & Sexual Violence
      • Health Clinics
      • Mental Health
      • Opioids
      • More
      Individuals & Families
      • Children & Youth
      • Federal Workforce
      • Immigrants
      • Military & Veterans
      • New Residents
      • Older Adults
      • Parents
      • People with Disabilities
      • Volunteers
      • More
      Land Use & Planning
      • Comprehensive Plan
      • County Capital Projects
      • Land Records
      • Parks Planning
      • Planning Projects
      • Research Tools
      • Transportation Projects
      • Urban Centers
      • More
      Library & Education
      • Adult Education
      • Early Childhood Programs
      • Library Branches
      • Library Catalog Search
      • Public Schools
      • More
      Parks & Recreation
      • Arts
      • Athletic Fields
      • Camps
      • Community Centers
      • Parktakes Classes
      • Rec Centers
      • Senior Centers
      • Teen Centers
      • Trails
      • More
      Permits & Licenses
      • Birth & Death Certificates
      • Building
      • Child Care
      • Dogs
      • Health
      • Marriage
      • Park Use
      • Solicitors
      • More
      Property & Housing
      • Affordable Housing
      • Code & Zoning
      • Neighborhoods
      • Real Estate Values
      • Recycling & Trash
      • Tenant Landlord Issues
      • Utilities
      • More
      Public Safety & Emergencies
      • 9-1-1
      • Emergency Preparedness
      • Fire & Rescue
      • Gun Violence Prevention
      • Police
      • Scams
      • Sheriff
      • Storm Center
      • More
      Roads & Commuting
      • Bike & Walk
      • Connector Bus
      • Metrobus & Metrorail
      • Park & Ride
      • Pedestrian Safety
      • Road Maintenance/VDOT
      • Street Parking
      • Toll Roads
      • Transportation Projects
      • More
      Taxes & Fees
      • Car Taxes
      • Park Fees
      • Real Estate Taxes
      • Tax Relief
      • Trash Disposal Fees
      • More
      Voting & Elections
      • Absentee Voting
      • Early Voting
      • Election Results
      • Polling Places
      • Voter Registration
      • More
      Weather & Climate
      • Air Quality
      • Climate Action Dashboard
      • Extreme Heat
      • Floods
      • Ready Fairfax
      • Resilient Fairfax
      • Snow
      • Tornadoes
      • More
  • Business
    • Business & Construction
      • Building Permits
      • Code & Zoning
      • Land Use
      • More
      Business Services
      • Business Emergency Preparedness
      • Business Taxes
      • Consumer Services
      • Employer Transportation Service
      • Green Business Partners Program
      • Home-Based Business
      • Regulation & Licensing
      • Small Business
      • Starting a Business
      • Workplace Issues
      • More
      Doing Business with Fairfax
      • Contracting and Procurement
      • Current Solicitations
      • Permits
      • Vendor Pitch Portal
      • More
  • Government
    • About
      • Codes & Standards
      • Countywide Strategic Plan
      • Facilities & Locations
      • History of Fairfax County
      • Operating Status
      • More
      Board of Supervisors
      • Auditor
      • Board Members
      • Boards, Authorities & Commissions
      • Clerk Services
      • Committees
      • Meetings & Agendas
      • More
      Budget & Finance
      • Bonds
      • Budget
      • Financial Transparency
      • Unclaimed Money
      • More
      Departments & Agencies
      Jobs & Employment
      • Full-Time Openings
      • Internships
      • Seasonal & Non-Merit
      Maps & Data
      • Countywide Data Analytics
      • Demographics
      • Geographic Information Systems
      • Interactive Data Tools
      • More
      One Fairfax
      • Digital Equity
      • Inclusive Engagement
      • Trust Policy
  • Fairfax County Virginia
  • Services
    • Find
      • Animal Services
      • Health Clinics
      • Jobs
      • Library Resources
      • Lost or Found Pet
      • Mental Health Support
      • Park Classes
      • Real Estate Values
      • Recycling & Trash
      • Volunteer Opportunities
      • More
      Pay
      • Business Taxes
      • Car Taxes
      • Dog Licenses
      • Driving & Parking Fines
      • False Alarm Fees
      • Real Estate/Property Taxes
      • SACC Payments
      • More
      Register/Apply
      • Basic Needs & Assistance
      • Building Inspections
      • Car Registration
      • Fairfax Alerts
      • Permits & Licenses
      • Tax Relief
      • Vote
      • More
      Report
      • Animal Control Issues
      • Consumer Complaints
      • Crime
      • Domestic Violence
      • Financial Crimes
      • Neighborhood Complaints
      • Road Issues to VDOT
      • Street Light Outages
      • More
  • Connect
    • Alerts, Emails & Apps
      • Email Subscriptions
      • Fairfax Alerts
      • Mobile App
      • More
      Community Engagement
      • Surveys & Projects
      Contact
      • Directory
      • Hotlines & Emergency Numbers
      • VDOT
      • VFOIA Requests
      • More
      News & Events
      • Daily Headlines
      • Emergency Information Blog
      • Events Calendar
      • NewsCenter
      • NotiCentro (Spanish)
      • Public Meetings Calendar
      • More
      Social Media
      • Comments Policy
      • Directory of Accounts
      • More
      TV, Video & Podcasts
      • Channel 16
      • Podcasts & Radio
      • YouTube
      • More
  • TRANSLATE
    • Language Selection

      To change the language of this website, click the drop-down list and select the desired language. The Fairfax County Web site is being translated through "machine translation" powered by Google Translate. Disclaimer

  1. Home
  2. Health and Human Services
  3. Eviction Prevention
  4. Required Forms

Health and Human Services Alert:

Fairfax County Emergency Rent Assistance Program

high rise building beautiful sunset

 

Required Forms & Documentation

 

LANDLORD FORMS

1. FEDERAL W-9  FORMpdf logo– Upload this form on the Landlord Accounts page in the Landlord Portal. Once you do so, it will be attached to all requests you make.

2. A CURRENT RENT LEDGER

     Template to Usepdf logo

REQUEST FORMS AND DOCUMENTATION

All requests must include the following, which can be uploaded to the Landlord Portal as part of your request:

1. A CURRENT AND VALID LEASE

2. A COMPLETED LANDLORD TENANT AGREEMENT 

     English / Spanish/Español

3. A COMPLETED SELF-CERTIFICATION OF LOSS OF INCOME/SIGNIFICANT COSTS/FINANCIAL HARDSHIP

     English / Spanish/Español

4. INCOME VERIFICATION FOR ALL TENANTS WHO EARN INCOME, FOR THE MOST RECENT FOUR WEEKS.       
    ACCEPTABLE DOCUMENTATION INCLUDES:

  • Pay stubs
  • Bank statements (one most recent)
  • A letter from the employer
  • Social security documents
  • Pension documents
  • Unemployment insurance award letter
  • Income tax returns
  • Child support documents
  • Cash Income Certification – For use only if other income documents are not available.
    English / Spanish/Español
  • Zero Income Certification – For use for adults in the household who do not have any income. 
    English / Spanish/Español

 

 

 

View Eviction Prevention Main Page for More Information and Resources on Maintaining Stable Housing.

 

 

 

Access Here

Recent Interactions

    Ask Fairfax

    Terms & Conditions
    Live chat available Search our site
    • Translate
    • Awards
    • Site Feedback
    • PRIVACY POLICY & COPYRIGHT
    Main Address

    12000 Government Center Pkwy
    Fairfax, VA 22035

    Phone

    703-324-7329

    TTY 711

    Site Tools
    • Website Accessibility
    • Translate
    • Download Mobile App
    Support
    • ADA Accessibility
    • FOIA Requests
    • Website Administrator
    Additional Resources
    • Fairfax County Public Schools
    • Economic Development Authority
    • Visit Fairfax
    • Council of Governments
    • Commonwealth of Virginia
    • USA.gov
    • Calendar
    • Channel 16
    • Mail
    • Security
    • WIFI
    • Facebook
    • Twitter
    • Instagram
    • YouTube
    • Mobile

    The Official Site of Fairfax County