Chametz Agreement 5785 - Form - Congregation Har Shalom

Chametz Agreement 5785

Mekhirat Chametz Agreement: Pesach 5785

Please complete this Mekhirat Chametz Agreement form no later than 11:00 AM on Friday, April 11.

Click HERE for a printable version.

* First Name

* Last Name

* Email

Address Line 1

Address Line 2

City

State

Zip Code

Do You Have An Additional Address Where CHametz Might Be Found?

Address Line 1

Address Line 2

City

State

Zip Code

* I hereby designate The Har Shalom Clergy to act on my behalf in selling the chametz in my possession. I understand that chametz will return to my possession at the conclusion of Pesach.

I hereby designate The Har Shalom Clergy to act on my behalf in selling the chametz in my possession. I understand that chametz will return to my possession at the conclusion of Pesach.

* Electronic Signature

* Date

Donation to the Clergy’s Discretionary Fund (enter amount)

Wed, June 25 2025 29 Sivan 5785

Congregation Har Shalom
11510 Falls Road | Potomac, MD 20854
Tel.: 301-299-7087 | Fax: 301-299-2247

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