Bill Sale of Chometz

I appoint the Rabbis of Cleveland as my agents to sell all Chometz and Chometz products which are in my home and property. I also authorize them to lease out all of the areas where Chometz can be found.
Date(*)
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Name(*)
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Home address(*)
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Work address(*)
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Signature(*)
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By typing my name in this filed, I acknowledge that this is equivalent to my signature and therefore abide by the rules of this agreement.

Please note that preferably all areas that contain Chometz should be designated and not entered/opened for the duration of the holiday of Pesach.