Chometz Sale Authorization Form
Rabbi Grussgott will be available to arrange
(1) Every morning after Shacharit
(2) Sunday after Mincha/Maariv
You can also pick up the form at the shul during office hours 9:30am-1:
If you cannot fill out the form in person with Rabbi Grussgott, please contact Rabbi Grussgott to make other arrangements.
Sale of Chametz
AUTHORIZATION -
DELEGATION OF POWER AND AUTHORITY FOR THE SALE OF CHOMETZ
(and the Bill of Sale executed in connection with such sale)
I, _____________________________________________, hereby fully empower and authorize Rabbi Moshe Grussgott and Rabbi
Stephen Friedman and anyone they may designate as a substitute in their stead, to sell, transfer and convey before the upcoming “Pesach”
all legal right and title to my “Chometz” to a non-Jew of their choice.
The term “Chometz” is intended and shall be understood to include, without limitation, any product made of wheat, barley, oats, rye or
spelt and any mixture or derivative thereof, as more particularly defined in and by Torah and Rabbinic Law and Jewish Tradition.
Additionally, without limiting the generality of the foregoing, “Chometz” may include the following items: schnapps and spirits; beer;
cereals; noodle and pasta products; barley; ingredients used in baking; frozen foods; crackers; baked products; pet food; vitamins; wheat
germ; pickles; mixes; condiments (e.g., ketchup, vinegar, etc.); assorted groceries; canned foods, etc.
The aforementioned “Chometz” items are located and may be found primarily in the following areas (please CHECK ALL areas that
may apply. In addition, please execute a SEPARATE Authorization for the sale of “Chometz” located at an Office and/or Business):
___Kitchen cabinets ___Desk ___Investment property located at:
___Breakfront/China closet ___Attic _____________________________________________
___Liquor cabinet ___Pantry ___Car (which will not be used on “Pesach”)
___Medicine/Bathroom cabinets ___Garage which is stored at:
___Refrigerator/Freezer ___Closet/Cabinets ___Neighbor’s or relative’s house located at:
___Shed, Basement or Storage area ___Locker at school _____________________________________________
and shall include all “Chometz” and/or mixtures containing “Chometz” that is or may be knowingly or unknowingly in my possession (as
“possession” is defined in and by Torah and Rabbinic Law and Jewish Tradition), or to which I have or may have legal responsibility in
whole or in part (including corporations or other business entities which own or deal in “Chometz” in which I may have an ownership
interest), or transit goods which may be delivered to me, during the period commencing as of 11:46 AM on Friday, April 22nd 2016
through 9:45 PM on Saturday, April 30th 2016; PLEASE NOTE: THE SALE WILL TAKE PLACE AS OF 11:46 AM ON Friday,
APRIL 22nd, 2016 THROUGH 9:45 PM ON Saturday April 30th , 2016.
I further empower and authorize Rabbi Stephen Friedman or Rabbi Moshe Grussgott and anyone they may designate as a substitute in
their stead, to lease or to sell, in the manner and for the time period they may deem appropriate, the places and areas where the “Chometz”
items may be located. In addition, the key necessary to gain access to said places and areas where the “Chometz” items may be located
can be obtained by contacting me (or, if you will be away for “Pesach”, indicate whether the doorman or a neighbor has the keys):
.
I hereby understand and agree that the buyer of the aforementioned “Chometz” items shall have, with the assistance and cooperation of
Rabbi Stephen Friedman or Rabbi Moshe Grussgott and anyone they may designate as a substitute in their stead, free access to the
“Chometz” items which he will be acquiring and to any area that will be leased or sold to him.
The “Chometz” items located in the areas set forth above have an approximate value of $____________________. (Appropriate
amounts and value of individual products may be outlined, if so desired, on the reverse side of this Authorization.) The precise
assessment and valuation of the “Chometz” items that are being sold will occur after “Pesach”. The buyer’s deposit in connection with
the purchase of the “Chometz” will be paid to Rabbi Stephen Friedman or Rabbi Moshe Grussgott or anyone they may designate as a
My authorization and delegation of power set forth in this Authorization shall become binding upon my execution of this Authorization in
the space set forth below, and this Authorization, when delivered to the buyer with the bill of sale, shall have the same force and effect as
(If you will be East of New York at the beginning of Pesach, or in a time zone West of New York at the end of Pesach, please
indicate here): ____ East at the beginning ____ West at the end
Address: ______________________________________________________________ Phone: ___________________________
E-Mail Address: __________________________________ Signature: __________________________________________