By filling out the form below, I (we) am (are) hereby appointing Rabbi Nachi Klein (or anyone he may choose to act as his agent in his place), to serve as my agent to sell all Chametz or Chametz mixtures that is in my possession to a non-Jew of his choice.
Please read and follow carefully. By submitting this form, you agree to all statements listed in the document. Please check all relevant boxes.
It is preferable to see the Rabbi personally (cell 323-206-2207) to validate this authorization with a "kinyan suddar", the handkerchief modality.