Apply For Zakat Assistance

Apply For Zakat Assistance

This application includes personal and confidential information intended only for restricted, internal use by authorized personnel exclusively for evaluation of Zakat/Sadaqah requests.

Full Name*

Phone Number*

Phone

Email Address*

Date Of Birth*

What is your gender?*

Select or enter value

Which category best describes you?*

Select or enter value

What country are you from?*

Select or enter value

What is your address?*

City*

State*

Zip Code*

What is your employment status?*

Select or enter value

How many dependents are living with you?*

Why are you applying for Zakat?*

Please provide the names and phone numbers of at least 2 references*

What is your total monthly income?*

How much Zakat are you requesting?*

Select

If other, please enter the amount*

Please upload a copy of your photo ID, latest bank statement & any supporting documents*

Drag and drop files here or

I testify in front of Allah (swt) that the information provided in this application is true and accurate to the best of my knowledge. I agree that this information provided in this application is to be used by the committee for DDIC Zakat request purposes only. I agree to and understand that DDIC may share my information with other zakat committees including but not limited to my name, aid received, approval amounts, and applications status.*

Send me a copy of my responses

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