Form 2920-EM PDF Details

Read each page carefully and answer every question.

Someone else: if you are applying for someone other than yourself, check boxes or complete blank spaces as it applies to the person for whom the application is made.

SNAP: if you are also applying for SNAP, we must take action on your SNAP application within 30 days from the date you submit your application.

Prior months: if you are applying for Medicaid, you may request payment for any medical expenses you had in the three months prior to this medical application.

Help: need help with your application? Call 1-800-992-0900 (voice) or 1-800-326-6888 (TTY).

QuestionAnswer
Form NameForm 2920-EM
Form Length22 pages
Fillable?Yes
Fillable fields576
Avg. time to fill out60+ min
Edition07/26
Issuing agencyDivision of Social Services
Matches the agency's fileYes, checked October 4, 2026
Other names2920-EM, 2920EM, Form 2920-EM, Application for Assistance, Nevada MAABD SNAP application
Official sourceForm 2920-EM (Rev 07/26), Division of Social Services

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