Authorization for the Sale of Hametz (food, liquor, etc--products containing wheat, barley, spelt, oats, or rye--which are not kosher for Passover)
I, the undersigned, fully empower Rabbi Michelle Dardashti, or someone she designates, to act in my place and stead and on my behalf, to sell all hametz possessed by me knowingly or unknowingly, or for which I have been designated proxy, as defined by Torah and Rabbinic law, and to lease all places in which hametz owned by me, as specified, below. This transaction will be in effect for the duration of Pesah, which this year begins at sundown on Friday, April 19th and runs through Saturday, April 27th. (Filling out this form means that your hametz will not belong to you from Friday morning, 4/19 around 10:30am until about 10:00pm on 4/27!)
Email address *
Address(es) *
Your answer
The hametz I possess includes the following: *
Please include: Type of hametz (food, liquor, toiletries, etc.), location where items will be stored at above address (i.e. kitchen cabinet, basement freezer, etc) and their approximate values (if uncertain, it is better to underestimate than overestimate) 
Your answer
Today's date *
Please type your name as your electronic signature: *
Your answer
Your cell phone number:
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