- Home
- Departments
- Health & Human Services
- Basic Assistance
- Forms and Documents
Forms and Documents
- Cash Contribution Form, Fill-in (pdf)
- CLARITY ROI - Client Consent Release (pdf)
- Employment Verification Form, Fill-in (pdf)
- Essential Service - Past Due, Fill-in (pdf)
- HHS Program Guidelines (pdf)
- Income-in-Kind Form, Fill-in (pdf)
- Landlord Letter - Prospective, Fill-in (pdf)
- Landlord Letter - Past Due, Fill-in (pdf)
- Mortgage Letter, Past Due - Fill-in (pdf)
- New Employer Form, Fill-in (pdf)
- Nye County HHS Application, NEW 3-21 - FILL IN (pdf)
- Nye County HHS Application, Additional Adults Page (pdf)
- Nye County HHS Application, Additional Child Page (pdf)
- Nye County HHS Application, Additional Household Members Page (pdf)
- Nye County HHS Application, Additional Veterans Page (pdf)
- Nye County HHS Application, Authorization for Release of Info (pdf)
- Rent Security Deposit, Fill-in (pdf)
- Rental Verification - HHS, Fill-in (pdf)
- Self Employment Form, Fill-in (pdf)
- Utility Letter - Past Due, Fill-in (pdf)
- Utility Security Deposit, Fill-in (pdf)
- VEA Pre-Pay Letter, Fill-in (pdf)
- W-9 Form and Letter (pdf)