Al-Ihsan Zakat Application - Al-Ihsan Educational Foundation

Zakat Application

Important: It is mandatory to complete all relevant fields in this form.

Step 1 of 7

Personal Information

Name(Required)

First Middle Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Note: A residential address is required. Do not use a P. O. Box.

Family Information

Marital Status(Required)

Name of Spouse (If applicable):(Required)

Full Name

Number of dependents(Required)

1) Name of Dependent(Required)

First

1) Age of Dependent(Required)

1) Relationship to dependent(Required)

2) Name of Dependent(Required)

First

2) Age of Dependent(Required)

2) Relationship to dependent(Required)

3) Name of Dependent(Required)

First

3) Age of Dependent(Required)

3) Relationship to dependent(Required)

4) Name of Dependent(Required)

First

4) Age of Dependent(Required)

4) Relationship to dependent(Required)

5) Name of Dependent(Required)

First

5) Age of Dependent(Required)

5) Relationship to dependent(Required)

Additional Information (Use this section to provide any additional information regarding your dependents)(Required)

Employer Information

Name of Employer or Previous Employer:(Required)

First Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Date of Last Employment(Required)

Reason for leaving(Required)

What is Your Total Household Income in The Previous Calendar Year?(Required)

Do You Receive Employment Insurance (EI) Benefits?(Required)

Enter The Employment Insurance (EI) Amount?(Required)

Do You or Your Family Receive Any Social Assistance?(Required)

Enter The Social Assistance Amount?(Required)

Personal Information

Personal Contact Information

Family Information

Employer Information

Income, Benefits, and Expenditure Information

Uploading Documents

Additional Information and Declaration

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