Sale of Chametz

The undersigned authorize(s) Rabbi Yaakov Gibber of Boca Jewish Center/Shaaray Tefilla in Boca Raton, Florida, to act on my/our behalf and to sell, before the coming Passover, all my/our Chametz as enumerated below, all in accordance with Jewish Law and prevalent Jewish custom. The Chametz is found especially at (list address(s)):

* Address where Chametz is stored

Home - please provide complete address including apartment # if appropriate.

* City, State, Zipcode

Additional Address

i.e. office, dorm, or vacation home... - please provide complete address full street address plus city, state and zip code.

This authorization includes the sale of Chametz that is in my/our possession, and also goods that would be delivered to me/us during the period after sundown on the evening of April 5, 2023 until nightfall on April 13, 2023, as well as chametz which I/we may own in full or in part through a controlling interest (as defined in the U.S. Securities Laws) in shares of stock in corporations which sell or deal in chametz. All such chametz is to be sold to a Non-Jew of the Rabbi’s choosing, within the time that it is still legally permitted to do so. The purchaser shall also have free access to the chametz or any part thereof,and to any storage area in my/our possession which will be rented to him together with the sale. The place where the chametz is located is to be rented to the buyer for the period of, after sundown on April 5, 2023 through nightfall on April 13, 2023, and the Rabbi is authorized to act as agent for such rental.

Incorporated by reference in this document, are the terms and conditions contained in the omnibus bill of sale and rental agreement to be executed by the Rabbi with the Non-Jew at the time of the sale. Such terms and conditions shall be deemed as if set forth expressly in this Authorization. This authorization shall be binding by my/our signature(s) below, or by the kinyan (form of legal transfer under Jewish Law) constituted by the taking hold of a garment.

* Executed this

Day of the Month

* day of

Month of the Year

* 2023, of the Common Era, in the city, town, or unincorporated township of

City

without any reservations whether stated or implied, and in good faith.

* First Name

* Last Name

* e-mail address

* Phone Number

Specify the Location of "Other" Chametz

* Total Approximate Value of Chametz

For those who will be away all of Pesach, the keys providing access to the Chametz sold above may be found with:

Name of contact

Phone number of contact

Address of contact

If you or your Chametz will be in a different time zone for Pesach, please provide details so that your Chametz will be sold and repurchased at the appropriate time:

$ Ma'os Chittim Contribution

There is no charge for the service of acting as your agent for the Sale of Chametz. Many have the custom to make their gift for Ma'os Chittim to fulfill two Mitzvahs at the same time. All funds collected with this form are used to provide Matzah and other Passover foods and services to those in need. Your generosity is greatly appreciated.

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