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Chametz Agreement 5785
Please verify reCaptcha before submitting the form.
Mekhirat Chametz Agreement:
Pesach
5785
Please complete this
Mekhirat Chametz
Agreement form no later than 11:00 AM on Friday, April 11.
Click
HERE
for a printable version.
*
First Name
*
Last Name
*
Email
Address Line 1
Address Line 2
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Do You Have An Additional Address Where CHametz Might Be Found?
No
Yes
Address Line 1
Address Line 2
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
*
I hereby designate The Har Shalom Clergy to act on my behalf in selling the chametz in my possession. I understand that chametz will return to my possession at the conclusion of Pesach.
I hereby designate The Har Shalom Clergy to act on my behalf in selling the chametz in my possession. I understand that chametz will return to my possession at the conclusion of Pesach.
*
Electronic Signature
*
Date
Donation to the Clergy’s Discretionary Fund (enter amount)
Thu, April 3 2025 5 Nisan 5785