Hametz Sale Authorization Form

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Please note that after submitting this form, you will receive a confirmation email. If you do not receive a confirmation email, please contact the rabbi.

Email *

Check off the box on the left *

I, the undersigned, fully empower and permit Gavriel Bellino or his designee to act in my place and stead, to sell all Hametz possessed by me knowingly or unknowingly, as defined by Torah and Rabbinic law, and to lease all places in which Hametz owned by me may be found, especially at the address(es) listed below:

Required

First Name *

Last Name *

Primary Address *

Apartment

City *

State *

Zip *

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This form was created inside of Sixth Street Community Synagogue.