DELIVER TO RABBI MEHLMAN OR FAX BACK TO: 212-769-1164
“AUTHORIZATION”
DELEGATION OF POWER OF AUTHORITY FOR SALE OF CHOMETZ
(and the Bill of Sale executed in connection with such sale)
I, _____________________________, hereby fully empower and authorize Rabbi Aaron D. Mehlman or
anyone else he may designate as a substitute in his stead to sell and transfer before the coming “Pesach” all legal
title to my “CHOMETZ”.
Chometz is understood but not limited to mean any product made of barley, oats, wheat, rye or spelt, or
any mixture or derivative in accordance with Jewish Law and Tradition. Chometz may consist of among other
things: Schnapps, cereals, noodle products, barley, baking ingredients, frozen items, crackers, baked products, pet
food, beer, vitamins, wheat germ, pickles, mixes, condiments, (ketchup, vinegar, etc.) medical preparations,
assorted groceries, assorted canned foods, Chometz affixed to utensils, to toys, to books, to Seforim, to
appliances, to baking tools, etc.
The above items are to be found primarily in (check all that apply):
 Liquor cabinet
 Shed
 Basement Closets/Storage
 Kitchen cabinets
 Office/business
 Investment property
 Breakfront
 Attic
 Storage area
 Crawl space
 Pantry
 Car (not being used)
 Briefcase
 Children’s knapsacks
stored at: __________________
 Refrigerator/freezer
 Desk drawers/Office
 Medicine chest/Bathroom Freezer
 Garage
 Fridge/freezer at work
Cabinet/Vanity
 Locker at business/school
 Neighbor’s House
Address: _________________
As well as all the Chometz and/or mixtures containing Chometz that is knowingly or unknowingly in my
possession, or that to which I have legal ownership or responsibility in whole or in part, or shares, stock or business
interests in corporations which own or deal in Chometz (including all transit goods which should be delivered to me
during the period of 4/03/15 through 4/11/15 inclusive) to a non-Jew of his choice.
I also authorize Rabbi Aaron D. Mehlman or anyone he may designate, to rent or sell as he deems fit and for the
appropriate duration, the places where the above-mentioned items are located. The key to those premises in which the
items are located can be found at (indicate if doorman has keys and include the location of car keys, if applicable):
The buyer shall have, through the aid and cooperation of the Rabbi, free access to the Chometz and/or mixtures
containing Chometz acquired by him.
The goods mentioned above have an approximate value of $______________. Appropriate amounts and value of
individual products may be outlined, if desired, on reverse side of this sheet.
The exact assessment of the quantity and value of the goods mentioned above will take place after Pesach. The
buyer’s deposit is to be paid to Rabbi Aaron D. Mehlman or whomever he may designate. This authorization is made
binding by my signature below which, when given with the bill of sale, will be considered as if I had actually signed the
bill of sale.
The authorization is further legalized by what is known as “Kinyan Suddar”, “Taking hold of a garment”, and is also
intended to conform to the criteria of secular law by the use of any appropriate legal instrument to achieve this objective.
Date: ______________Name: _____________________________________Phone: __________________
Address: ______________________________________________________________________________
Business Address: ______________________________________________________________________
E-mail:________________________________________________________________________________
Signed: ______________________________________________________________________________
Please check if going to Eretz Yisroel