Mechiras Chametz

IMPORTANT

PLEASE DO NOT USE THIS SURVEY - EXIT AND GO TO

https://www.research.net/r/Chometz

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* 1. Last Name

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* 2. First Name

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* 3. Cell Phone Number

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* 4. Email Address

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* 5. Home Address

Address

City

State

Zip

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* 6. Address of Premises That Contain Chametz

Address

City

State

Zip

Chametz Location One

Chametz Location Two

Chametz Location Three

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* 7. Additional Addresses and Locations of Chametz

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* 8. Please check which chametz items will be included in this sale:

Liquor

Grocceries

Perfumes

Cosmetics

Medications

Stocks in Chametz Companies

Other (please specify)

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* 9. Location of Keys or number you can be reached at:

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* 10. An Underestimated Approximate Value of Chametz:

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* 11. City that I will be in at the start of Pesach:

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* 12. City that I will be in at the close of Pesach:

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* 13. Other Comments:

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* 14. One going away for Pesach may wish to be exempt from Bedikas Chametz, If so, it is preferable to lease out the entire home. Alternatively, one may exclude one room from the lease to perform Bedikas Chametz in that room. Are you going to be away from the address listed above the entire Pesach and wish to lease your home?

Yes