Get Rep Payee Referral Form 1-2014.pdf - Clark County Nevada - Clarkcountynv

Completing the Rep Payee Referral Form is essential for referring individuals to the Representative Payee Program in Clark County, Nevada. This guide will provide you with clear and concise instructions to ensure the form is filled out accurately and efficiently.

Follow the steps to complete the Rep Payee Referral Form online.

1. Click the ‘Get Form’ button to obtain the Rep Payee Referral Form. This action will allow you to access the form and open it in your preferred document editor.
2. Begin filling out the form by providing the date at the top of the document. Ensure that all entries are completed accurately.
3. In the section labeled 'Sent By,' provide your name, telephone number, and agency to ensure that the referral can be tracked and followed up on.
4. Fill out the 'Name of Proposed Client' and include any other names the client is known by in the 'AKA' section.
5. Continue with personal details such as age, date of birth, birthplace, and ethnicity. It is important to input all relevant information to aid in the evaluation process.
6. Provide the client’s social security number and any medical or VA identification numbers if applicable. This information is crucial for identifying the client accurately.
7. Indicate the address where the proposed client resides, and if they live alone, answer accordingly in the relevant section.
8. Complete sections regarding the client’s financial situation, including sources of income and existing assets. Include any attached documentation that supports your entries.
9. After completing all sections, ensure that you have included any necessary supporting documents, such as medical records and legal guardianship information.
10. Finally, you can save your changes, download the form, print, or share it as required. Be sure to send the completed form to the Clark County Public Guardian’s office as indicated.

Take the next step in helping someone in need by completing the Rep Payee Referral Form online today.