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Hametz Agreement 2024
Please verify reCaptcha before submitting the form.
Mekhirat
H
ametz Agreement
Pesach
5784/2024
Please complete this
Mekhirat
H
ametz
Agreement form no later than 11:00 AM on Wednesday, April 5th.
Click
HERE
for a fillable PDF 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 Hametz 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 Rabbi Adam J. Raskin to act on my behalf in selling the hametz in my possession. I understand that hametz will return to my possession after 8:45 PM on Tuesday, April 30th.
I hereby designate Rabbi Adam J. Raskin to act on my behalf in selling the hametz in my possession. I understand that hametz will return to my possession after 8:45 PM on Tuesday, April 30th.
*
Electronic Signature
*
Date
Donation to the Rabbi’s Discretionary Fund (enter amount)
Sun, December 22 2024 21 Kislev 5785