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Shtar Harsha'ah

(Document of Permission)

For more information, visit http://www.koach.org/hametzsale.htm

We, the undersigned, do authorize Rabbi Elyse Winick to act as our agent to write a Shtar M'khirah and sell our Hametz as necessary. We understand that any Hametz in our house will not be ours for use from Monday morning, March 25, 2013 until Tuesday, April 2, 2013 at 10:00 p.m. (your local time).

Please note that we are only able to handle Hametz sales in North America. For European and Israeli sales, please contact the Masorti Movement at masorti@masorti.org.

Your Information:

First Name  

Last Name  

Street Address  

Address (cont.)  

This document has been completed in (City)  

State/Province  

Zip/Postal Code  

Country  

US
Canada

(For European and Israeli sales, please contact the Masorti Movement at masorti@masorti.org.)

E-mail  

Phone  

This document was completed on  

Place where the hametz is stored  

Comments or Requests

Make a Donation:

It is customary to make a donation to accompany your document of sale. You can send the donation in any amount of your choosing. Use this form to make a donation to KOACH with your credit card online.

Donation  

Billing Information:

My billing address is the same as above

Street Address  

Address (cont.)  

City  

State/Province  

Zip/Postal Code  

Country  

US
Canada

Type of Card  

Visa MasterCard Discover Amex

Card Number  

(no dashes)

Cardholder Name  

CV Code  

For MasterCard or Visa, it's the last three digits in the signature area on the back of your card. For Amex, it's the four digits on the front of the card.

Expiration Date  

(mm/dd/yyyy)