[vc_row][vc_column][vc_column_text] Zakah / Sadaqah / Fitrah Application Form [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column] Applicant Name:* First Last Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Address* Eligible for Zakah? Yes No AmountNature of Situation:How did you hear about MCMC or referred by: * I declare all information provided on this form is true and correct.INSTRUCTIONS Submit a copy of SSN and copy of US govt. issued photo ID or valid foreign passport. An official referral letter/verification from a local masjid Imam will be needed for out of county/state applications. After providing all necessary information and required documents, processing of application will take 2 to 3 weeks Do not contact MCMC before 2 weeks. MCMC will contact you on the provided number. Disclaimer Only one application/person per household/address will be reviewed.. Only US based individuals with the legal status will be considered.. Applicant is responsible for reporting Zakah/Sadaqah/Fitra to the IRS and other agencies, if necessary. Please be advised, MCMC has established a cap for individuals and/or organization. Zakah committee’s decision is final, and it will not be disclosed for discussion. [/vc_column][/vc_row]