Forms and Documents

  1. Cash Contribution Form, Fill-in (pdf)
  2. CLARITY ROI - Client Consent Release (pdf)
  3. Employment Verification Form, Fill-in (pdf)
  4. Essential Service - Past Due, Fill-in (pdf)
  5. HHS Program Guidelines (pdf)
  6. Income-in-Kind Form, Fill-in (pdf)
  7. Landlord Letter - Prospective, Fill-in (pdf)
  8. Landlord Letter - Past Due, Fill-in (pdf)
  9. Mortgage Letter, Past Due - Fill-in (pdf)
  10. New Employer Form, Fill-in (pdf)
  11. Nye County HHS Application for Assistance, Revised December 2022, Fill-in (pdf)
  12. Nye County HHS Application, Additional Adults Page (pdf)
  13. Nye County HHS Application, Additional Child Page (pdf)
  14. Nye County HHS Application, Additional Household Members Page (pdf)
  15. Nye County HHS Application, Additional Veterans Page (pdf)
  16. Nye County HHS Application, Authorization for Release of Info (pdf)
  17. Rent Security Deposit, Fill-in (pdf)
  18. Rental Verification - HHS, Fill-in (pdf)
  19. Self Employment Form, Fill-in (pdf)
  20. Utility Letter - Past Due, Fill-in (pdf)
  21. Utility Security Deposit, Fill-in (pdf)
  22. VEA Pre-Pay Letter, Fill-in (pdf)
  23. W-9 Form and Letter (pdf)
  24. Guidelines (pdf)
  25. Mortgage Letter - Past Due
  26. Authorization - Release of Info (pdf)
  27. CLARITY - Client Consent Release (pdf)
  28. Employment Verification Form (pdf)
  29. HHS Program Guidelines (pdf)
  30. Landlord Letter - Past Due (pdf)
  31. Landlord Letter - Prospective (pdf)
  32. Nye County Application - Additional Household Members (pdf)
  33. Nye County Application - Additional Child (pdf)
  34. Nye County Application - Additional Veteran (pdf)
  35. Nye County Application - Authorization for Release of Info (pdf)
  36. Nye County Application for Assistance - NEW 3-21 (pdf)
  37. New Employer Form (pdf)
  38. Utility Letter - Past Due (pdf)
  39. VEA Pre-Pay Letter (pdf)
  40. Security Deposit Letter (pdf)
  41. Rental Verification Form (pdf)
  42. W-9 and Vendor Form (pdf)
  43. Self Employment Form (pdf)