Chametz Sale
We are providing a service through Washington Square Minyan to sell your chametz for the entirety of Pesach and thus avoid the prohibition of owning any chametz over the holiday. Complete this form to authorize Eli Gurock to sell your chametz. Typing your name and the date on the bottom of the form is equal to signing it.

Please note that the deadline to submit this form is Thursday, April 2, 2015, at noon.

I, *
Your answer
who reside at *
Your answer
declare the following chametz to be in my ownership *
(give location, room and separate address if necessary):
Your answer
including all chametz that is unknown to me that is either on my person, in my possession, or not in my possession but in my ownership, especially chametz that tends to harden and to adhere to the surface of pans, pots, or other cooking or eating utensils, of whatever nature.
Virtual Signature
I hereby authorize Eli Gurock to act as my sole agent in selling the abovementioned chametz. I understand the terms of sale to be as follows:
(1) The transaction can take place at any time prior to Friday, April 3, 2015, but will only take effect beginning 10:30AM on April 3, 2015.
(2) The abovementioned chametz will be sold to Sam Shipman, a non-Jew who will assume full (including legal) ownership of the named chametz.
(3) The sale price will be $100.00 to be paid as follows: five cents will be paid at the time of purchase with the remaining balance due on or before 9:03PM on Saturday, April 11, 2015.
(4) In the event that the balance is not remitted by this date and time, the sale will become void at that moment, and ownership of the abovementioned property will instantly revert to its original owner.
(5) Eli Gurock will hold the revenue from this sale temporarily on my behalf.
Please type your name *and the date* as a virtual signature *
Your answer
Today's date
Your answer
Please provide your email address so we can contact you if the balance is not paid by the end of the holiday. *
Your answer
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