ZAKAT APPLICATION

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    Instructions

    Please provide accurate and detailed information to enable a timely and effective application evaluation. Note: An incomplete form will not be considered for evaluation.

    Provide clear copies of:

    1. Photo ID: For the applicant, spouse, and all dependents; Driver’s License, State Issued ID, or Passport.

    2. Social Security Card (for all those that provided photo ID as identification).

    3. Lease agreement (if renting).

    4. Proof of income.

    5. Other documentation that might help in the evaluation, such as medical reports, receipts, billing statements, etc.

    • Note that all documentation provided is considered the SRIC property and will not be returned to the applicant.

    • The committee will examine all provided information and will contact the references.

    • Simply applying for Zakat does not mean automatic approval of the application.

    • Normal application process time is typically two (2) weeks from the receipt of the application and may be longer. The Zakat Committee will be contacting the applicant.

    Applicant Information (Please Print)









    ($)











    Reference: Notice: Please note that references should not be immediate relatives or people who live with you, nor Zakah recipients. Please list at least 2 names of anyone with whom you are familiar and who can confirm or verify the information you provided. Muslim references are preferred, at least one, but list all references.

    Please check and fill any of the following you have received within the last calendar year:

    Type of Income / Aid

    Amount ($)

    Last Date Received

    Frequency

    Salary from Job/work

    Social / Supplement Security income (SSI)

    Food Stamp

    Subsidized Housing, Public Housing

    Child Support

    Alimony

    Unemployment

    Zakah/sadaqah

    Other (specify)

    Total

    Please check and fill any of the following Expenses you may have:

    Type of expenses

    Amount ($)

    Last Date Received

    Frequency

    Rent

    Food

    Transportation

    Utilities (Bills)

    Other (specify)

    Total $

    Reference #1

    Reference #2

    Acknowledgement:

    I testify in front of ALLAH SWT that the information provided on this form is true and accurate to the best of my knowledge. I agree that the information provided in this application will be utilized in connection with this request for Zakah/Sadaqah.






      Instructions:

      • Form MUST be completely filled out and MUST be legible

      • Applicant MUST be 18 years or older

      • Membership is ONLY valid for a person who bears witness that: there is no God but ALLAH SWT and MUHAMMAD Peace Be Upon Him is HIS messenger.

      • Membership is ONLY valid from January 1st to December 31st of a calendar year upon full payment of required fees.

      • Donations of any type DO NOT constitute membership fees

      • Membership fee to $300 per person for the calendar year

      Please fill the details below

      Note:

      Please make check payable to: Shelter Rock Islamic Center and write MEMBERSHIP in memo area.
      To pay by Credit Card, please call the office at 516-744-6200
      Questions: Email info@sricli.com Or Call 516-744-6200

      App Link https://services.madinaapps.com/donation/clients/SRICMadina