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HUMAN SERVICES (LCHS)
620 Lake Avenue Silver Springs, Nevada 89429 Phone: (775) 577-5009 Fax: (775) 577-5093 www.lyon-county.org
If more than 4 household members, list additional household members in the 'Additional Information' block below.
Other Household Member #1
Other Household Member #2
Other Household Member #3
Other Household Member #4
(Check all that apply)
(age 60 or over)
(Parent/Children)
(Individuals/Families)
(Point of Contact)
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