Zakat Application
Please fill out the application as accurately as possible so we can help optimally. Unanswered questions or inaccurate answers may lead to delay or denial of application. You can email us at or call us at 201-667-2265
Full Name *
Your answer
Is this your first time applying for zakat with theBBNJ? *
Driver's License # (Or ID #) *
ID needs to have a photo of applicant
Your answer
Marriage Status *
Address 1 *
write N/A if Not Applicable
Your answer
Address 2 *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Number of Dependents under 18: *
Are you employed? *
Are you on any Government Assistance? *
Total Monthly Income: *
Your answer
Total Monthly Expenses: *
Your answer
Estimated Amount Needed: *
Your answer
Reason for Needed Amount* *
Your answer
Is your estimated wealth (reduced for any debt you owe) lower than $4,000 USD? (do not include the value of essentials such as residence, clothing, furniture, transportation, etc.) *
Do you authorize Building Blocks to act as an agent to distribute Zakat given by them on your behalf? *
Please provide any references (names and contact information) who we can discuss about your case *
Your answer
Documentation: Please also send copies of the following documents:
1 - Government Issued Identification (e.g. Driver's License or Passport)
2 - Most Recent Bank Statement
3 - Most Recent Tax Return

4 - Proof of Employment (if applicable)
5 - W-2 Form (if applicable)
6 - Past Due Utility Bill (if applicable)
7 - Past Due Rent Bill (if applicable)
8 - Eviction Letter (if applicable)

9 - Any other documentation that you feel is important to share

[If you cannot provide any of the documentation above, please send what you can and let us know why the other documentation is not available]

[Please reply to the e-mail and attach the documents. If you do not have scanned version or photos of the above, please mail the documentation to 600 Palisade Avenue, Union City, NJ 07087, and let us know the documents are being mailed by replying to the e-mail].

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