AGENCY APPOINTMENT FORM
FOR SELLING CHOMETZ
I ,_______________, residing at __________________________
Hereby authorize Rabbi Steven Bayar, who resides at 43 Haran Circle, Millburn, New Jersey, to act as my agent to all Chometz that may be in my possession, wherever it may be; at home, place of business or elsewhere, in accordance with the requirements and provisions of Jewish law.
Name ___________________________
Date ____________________________