Zakat Assistance Request

Zakat Request

MUHB's Zakat Program exists to support eligible members of our community who are experiencing financial hardship. All requests are reviewed with care, confidentiality, and in accordance with Islamic guidelines.

Please note: Submitting this form is the first step in the review process and does not guarantee assistance.

Before You Begin

This form is intended for individuals who are unable to meet basic needs such as housing, utilities, food, medical expenses, or urgent debt.
Zakat funds are distributed only to those who meet Islamic eligibility requirements.
You may be asked to provide documentation (such as a bill or notice) to help us assess your request.
All information shared will remain confidential and reviewed only by the Zakat Committee.

If you are unsure whether your situation qualifies for zakat, you are still encouraged to submit a request. Our committee will review each case with compassion and discretion.

Need immediate help?
If your situation is urgent, please indicate this clearly in the form and include any relevant deadlines.

Applicant Information

Basic contact information for follow-up and communication.

First Name

Last Name

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Current Employment Status

Household Information

Information about dependents and household responsibilities.

Marital Status

Number of Adults in Household

Number of Children / Dependents

Are you the primary provider for your household?

Yes

Type of Assistance Requested

Select the type of support you are seeking.

Amount Requested

Please briefly explain your current situation and need for assistance

Is this request urgent?

Yes (within 7 days)

Somewhat urgent (within 30 days)

Not urgent

Deadline for payment (if applicable)

Verification & Supporting Documents

To help us review requests fairly and responsibly, we may ask for documentation related to your request. Providing documents allows us to process applications more efficiently and ensure zakat funds are distributed according to Islamic guidelines.

Accepted documents may include:

Recent utility bills or rent statements
Medical bills or pharmacy invoices
Past-due notices or eviction warnings
Proof of income or loss of income (pay stub, termination notice, benefits letter)
Other documents relevant to your request

All documents are reviewed confidentially by the Zakat Committee and used only for the purpose of evaluating assistance requests.

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Zakat Assistance Application