MAB Zakat Application

MAB Zakat Application
Applicant Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Applicants Address

Street Address

CityState / Province

Postal / Zip Code
Currently Working?
If yes, Monthly Gross Income:
Receiving Government Assistance?
If yes, Monthly Gross Assistance Amount (SNAP, Cash, Rental Assistance etc.)
Please provide the assets currently you possess: Example:- Gold, Silver, Cash on Hand, Cash in Bank, Securities, Mutual Funds, Retirement accounts, Business Inventory or Other
Do you own your home?
Do you Qualify for Zakat?
Reason for Financial Assistance Request

0/0
Attach ID: (State ID or License, Passport etc.)

Cancelof
Acknowledgment
I acknowledge and affirm that all information I have provided in this application is true, complete, and accurate to the best of my knowledge. I understand that Zakat eligibility is a matter of personal responsibility, and that only Allah (SWT) and I truly know my financial condition and eligibility. I accept full accountability before Allah (SWT) for the accuracy of the information submitted.
Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Acknowledgment