MECHIRAS CHOMETZ FORM
DELEGATION OF POWER OF ATTORNEY FOR SALE OF CHOMETZ
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Be it known that I (name), *
At the below address *
The above mentioned items are to be found primarily at (address): *
Room(s): *
The above mentioned products have an approximate value of: *
I also authorize Rabbi Aharon Ciment to lease all or any property wherein the above mentioned items owned by me may be found as he deems fit , and for such a time which he believes to be proper.  The key to these premises is available at the address below: *
I authorize whoever has my key to open the premises to the buyer of my Chometz when he produces this document.  I also give Rabbi Aharon Ciment full power and authority to appoint a substitute in his stead with full power to sell and lease as provided herein.
By checking the box below you are agreeing that Rabbi Aharon Ciment will be your agent regarding the sale of your chometz. *
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