Fillable Department of Social Service (Clark County Nevada)

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Department of Social Service (Clark County Nevada)

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The Department of Social Service (Clark County Nevada) form is 2 pages long and contains:

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  • 8 check-boxes
  • 47 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Clark County Nevada

BROWSE CLARK COUNTY NEVADA (NV) FORMS

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Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702) 455-4270 • Fax (702) 455-5950
3
Landlord Assistance Application
Date of Application:
Landlord Information
Name:
Street address:
City: _
State: Zip Code:
Phone:
Email:
Property Information
Property Name
Street Address
City
Zip
Code
Parcel
ID
Date of
Acquisition
Total
# of
Units
Ownership
Documentation
Included.
Yes/No
Total amount of funds being requested:
Office Use Only:
Date Received:
Application #:
Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702) 455-4270 • Fax (702) 455-5950
4
Landlord Assistance Application
Primary Lease Holder Information
Property Name:
Primary Lease Holder Name:
If Primary Lease Holder’s address is the same as the property address, you may just enter Unit # below and
skip to the Phone field.
Street address: Unit #:
City:
Zip Code:
Phone:
Email:
A Tenant Notice was provided to the tenant for this unit:
Yes No
The following documents are included for this unit:
1. Lease Agreement: Yes No
2. Delinquency Notices: Yes No
3. COVID Confirmation: Yes No
The breakdown of itemized cost:
MM/YYYY
AMOUNT
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Deposit
/
$
TOTAL:
$
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Department of Social Service (Clark County Nevada)

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Completed 19 October 2021

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