Zakat / Sadqa aSSISTANCE FOrM

Zakat is a form of almsgiving, often collected by the Muslim Ummah. It is considered in Islam as a religious obligation, and by Quranic ranking, is next after prayer in importance. As per Quran “Yet you shall duly establish the Prayer. And you shall give the Zakat-Charity, and there with lend God a most goodly loan. For whatever good you advance for your souls, you shall find its reward with God in the Hereafter; yet it shall be far better and much greater in reward (Sûrat Al-Muzzammil, 73:20).”

Zakat / Sadqa Assistance Form

Name:(Required)

First Name Last Name

Type of Financial Aid Needed:

Date of Birth:

Phone Number:

Email:(Required)

Photo I.D. /Driver’s License#

Max. file size: 256 MB.

Type a question:

Financial Information

Current Employment Status:

Monthly Income:

Monthly Expenses:

Do you receive any other forms of financial assistance?

If yes, please specify:

Assistance Requested

Amount Requested:

Purpose of Assistance:

How will this assistance benefit you?

Supporting Documents (Attach if available)

Photo ID

Social Security Card

One Month's pay stubs

Most recent income tax return

Most recent bank statements

Rent Receipt

Any bills, eviction notices, etc.

File Upload

Drop files here or

Max. file size: 256 MB.

References (List the names of persons who can substantiate the information above)

1. Name:(Required)

First Name Last Name

Phone Number

Relationship

2. Name:(Required)

First Name Last Name

Phone Number

Relationship

Signature

Max. file size: 256 MB.

Date

4721 Moody Boulevard, Bunnell, Florida 32110, United States

Zakat / Sadqa aSSISTANCE FOrM