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General Assistance Pre-Screen Form

Please complete the following form to learn more about opportunities for General Assistance.

Please read the overview of General Assistance in Lyon County before submitting this pre-screen form. You'll find information on eligibility.

Do you receive Section 8, HUD, SIRHA?
How much rent do you pay each month?
Landlord/Apartment Name
Are any adult household members a student?
Have any household members served in the Military?
If served in the Military, is this person Service Connected?
Have any household members voluntarily quit or get fired from job in the last 90 days?
Are you applying for Social Security
Current Doctor
Have you ever been denied at the Administrative Law Judge Level (ALJ) in the Social Security process?
If so, when did this occur?