Sell Your Chametz Form

I the undersigned, fully empower and permit you to act in my place and stead, and on my behalf to sell all chametz possessed by me, knowingly or unknowingly as defined by the Torah and Rabbinic Law (e.g. chametz, possible chametz, and all kind of chametz mixtures).

Also chametz that tends to harden and adhere to surfaces of pans, pots, or cooking utensils, the utensils themselves, as well as pet food that contain chametz and mixtures thereof.

You are also empowered to lease all places wherein the chametz may be found, particularly at the address listed below, and elsewhere.

You have full right to appoint any agent or substitute in his stead and said substitute shall have full right to sell and lease as provided herein.

You also have the full power and right to act as he deems fit and proper in accordance with all the details of the Contract of Sale used in the transaction to sell all my chametz, chametz mixtures, etc., as provided herein. This power is in conformity with all Torah, Rabbinic and Civil laws.

Seller:

Chametz Location:

Additional chametz locations:

Note: The deadline for submissions is 11:59 pm (local time) on April 9, 2026.