Sale of Chametz for Pesach 2016
By filling out the form below, I am hereby appointing Rabbi Avi Stewart (and anyone he may choose to act as his agent in his place), to serve as my agent to sell all chometz that is in my possession to a non-Jew of his choice. The sale will take place on Erev Pesach (day before the start of Passover) on Friday April 22nd, 2016 will remain in the possession of the non-Jew for the duration of Pesach.

The assumption is that the owner and the chometz will both be in the Pacific time zone at the start and finish of the holiday, unless specified otherwise at the end of the form.

I hereby authorize Rabbi Avi Stewart to negotiate the sale of all chometz in my possession specifically, but not exclusively, what is located in the following rooms and closet: List here, as detailed as possible, the places where the chometz for sale will be (i.e. taped kitchen cabinets ...). Please check off the box to indicate authorization.
Required
Name:
Your answer
Phone Number:
Your answer
I further authorize Rabbi Avi Stewart to rent or sublease to the purchaser of this chometz the rooms or parts of the rooms in which the chometz is to be found. Please check the box to indicate authorization.
Required
Any chometz not in my possession but to which I have legal ownership or responsibility, in whole or part, or which may arrive during Pesach, is also included in this authorization. Please check the box to indicate authorization.
Required
The estimated total value of the chometz to be sold is $___________, including (list only substantial items, such as a case of whiskey. Please underestimate the value of the chometz).
Your answer
The purchaser has free access to the chometz upon request. Please check the box to indicate authorization.
Required
I also authorize Rabbi Stewart to rent or sell the following properties: (This is only for those who will not be at home at all during Pesach and are renting out their apartments to avoid “bedikah”.)
Your answer
6. Rabbi Stewart may choose any legal instrument in accord with the Halacha for negotiating the above mentioned transaction. Please check the box to indicate authorization.
Required
Address of Property where Chametz will be during Pesach: [Please include Street, City, Zip and Country]
Your answer
If not at home for Pesach, how can purchaser gain access to the premises (i.e. which neighbor has a key or phone # of seller)?
Your answer
Will you be in a different time zone on Erev Pesach or the last day of Pesach? If yes, fill in this box indicating where you will be at both the beginning and end of the chag.
Your answer
It is preferable to see the Rabbi personally (call 424-256-5134) to validate this authorization with a “kinyan suddar”. If that is difficult, this form can be submitted electronically by clicking on the button marked submit.
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