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SALE OF CHOMETZ  -  Authorization Form

               I fully empower and authorize Rabbi Dale Polakoff and/or Rabbi Ian Lichter of the Great Neck Synagogue to dispose
               of all Chometz that may be in my possession, or whose owners have authorized me to make such arrangements,
               wherever it may be, at home, place of business or elsewhere (knowingly or unknowingly). Rabbi Polakoff and/or
               Rabbi Lichter have full right to sell, dispose, conduct all transactions as they deem fit and proper for such time
               which they believe necessary, in accordance with the detailed hebrew contracts which are in their possession.

               The above power hereby given is meant to conform with all Torah and Rabbinic regulations, to meet the
               requirements of Jewish law and to concur with the laws of the State of New York.

               Most of the above mentioned Chometz is located at:

                                      (address)          (specific location at address - ie, kitchen, etc.)          (approximate value)

               1. ____________________________________    _________________________________________________          _______________

               2. ___________________________________     ________________________________________________           _______________

               3. ___________________________________     ________________________________________________           _______________

               4. ___________________________________     ________________________________________________           _______________

               To all of the above, I affix my signature.

               Signed   __________________________________________________________________    Date __________________________

               Print Name  ______________________________________________________________

               IF YOU WILL NOT BE IN GREAT NECK and will be in a different time zone for either the beginning or the end of
               Pesach, please fill out the following:

               For the beginning of Pesach, I will be in:        For the end of Pesach, I will be in:

               _______________________________________________________    ________________________________________________________

               This form must be emailed to or faxed to 516-487-6149 by
               Friday, April 15, 2022 by 9:00 a.m. Arrangements for the sale of chometz can also be made

                                                  SCOPE Magazine Passover 2022   64
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