Common use of DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI Clause in Contracts

DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI. (art. 46 del DPR 445 del 28.12.2000) Substitutive declaration of documents (art. 46 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) NAME (Married women must indicate: spinster’s name NOME.................................................................................................................................................... Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: PREFISSO............................................NUMERO......................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 e 76 del DPR 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenziale) 445/2000 for the hypothesis in false actions and declarations ................................................................................................................................................................ ................................................................................................................................................................ Luogo e data............................................. Place and date Il dichiarante The undrsigned Allegato “3” Attachment ‘3’

DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI. (art. 46 del DPR D.P.R. n. 445 del 28.12.2000) Substitutive declaration of documents (art. 46 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) NAME Name (Married women must indicate: spinster’s name name) NOME.................................................................................................................................................... ................................................................................................................................................................ Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: PREFISSO............................................NUMERO......................................................... ………………………………………………………........................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 artt. 75 e 76 del DPR D.P.R. n. 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenziale) 445/2000 for the hypothesis in false actions and declarations ................................................................................................................................................................ ................................................................................................................................................................ Luogo e data............................................. Place and date Il dichiarante The undrsigned Allegato “3” Attachment ‘3’

DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI. (art. 46 del DPR D.P.R. n. 445 del 28.12.2000) Substitutive declaration of documents (art. 46 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) NAME Name (Married women must indicate: spinster’s name name) NOME.................................................................................................................................................... ................................................................................................................................................................ Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: PREFISSO............................................NUMERO......................................................... ………………………………………………………........................................................... Telephone number consapevole delle responsabilità penali previste dagli artt. 75 e 76 del D.P.R. n. 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenziale) 445/2000 for the hypothesis in false actions and declarations Luogo e data............................................. Place and date Il dichiarante The undrsigned DICHIARAZIONI SOSTITUTIVE DELL’ATTO DI NOTORIETA’ Substitutive declaration of attested affidavit deed (artt. 19 e 47 del D.P.R. n. 445 del 28.12.2000) (artt. 19 and 47 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) Name (Married women must indicate: spinster’s name) NOME................................................................................................................................................................ Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: ………………………………………………………........................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 e 76 del DPR 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenziale) 445/2000 for the hypothesis in false actions and declarations ................................................................................................................................................................ ................................................................................................................................................................ Luogo e data............................................. Place and date Il dichiarante The undrsigned Allegato “3” undersigned Attachment ‘3’"4" Il/la sottoscritto/a nato/a a il I, the undersigned born in on in relazione all’incarico di : In relation to the position: ❏ Di non svolgere incarichi, né di avere titolarità di cariche in Enti di diritto privato regolati o finanziati dalla Pubblica Amministrazione, né di svolgere attività professionali; ❏ Not to carry out any assignments or professional activities and not to hold positions in private law entities governed or financed by the public administration; ❏ Di svolgere incarichi e/o avere titolarità di cariche in Enti di diritto privato regolati o finanziati dalla Pubblica Amministrazione e/o di svolgere attività professionali. In tal caso specificare : ❏ To carry out assignments or professional activities and not to hold positions in private law entities governed or financed by the public administration. Please, specify: Cariche/Incarichi/attività professionali Positions / assignments / professional activities Ente / Società Institution / Corporation Data inizio Start date Data fine End date Il/la sottoscritto/a si impegna, altresì, a comunicare tempestivamente eventuali variazioni del contenuto della presente dichiarazione e a rendere nel caso, una nuova dichiarazione sostitutiva. The undersigned will promptly notify any variations and provide a new declaration of certification, if necessary. Camerino,

DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI. (art. 46 del DPR D.P.R. n. 445 del 28.12.2000) Substitutive declaration of documents (art. 46 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) NAME Name (Married women must womenmust indicate: spinster’s name name) NOME.................................................................................................................................................... ................................................................................................................................................................ Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: PREFISSO............................................NUMERO......................................................... ………………………………………………………........................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 e 76 del DPR D.P.R. n. 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenzialeDecretopresidenziale) 445/2000 for the hypothesis in false actions and declarations ................................................................................................................................................................ ................................................................................................................................................................ Luogo e data............................................. Place and date Il dichiarante The undrsigned Allegato “3” Attachment ‘3’

DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI. (art. 46 del DPR D.P.R. n. 445 del 28.12.2000) Substitutive declaration of documents (art. 46 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) NAME Name (Married women must womenmust indicate: spinster’s name name) NOME.................................................................................................................................................... ................................................................................................................................................................ Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: PREFISSO............................................NUMERO......................................................... ………………………………………………………........................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 e 76 del D.P.R. n. 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decretopresidenziale) 445/2000 for the hypothesis in false actions and declarations Luogo e data............................................. Place and date Il dichiarante The undrsigned DICHIARAZIONI SOSTITUTIVE DELL’ATTO DI NOTORIETA’ Substitutive declaration of attested affidavit deed (artt. 19 e 47 del D.P.R. n. 445 del 28.12.2000) (artt. 19 and 47 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) Name (Married womenmust indicate: spinster’s name) NOME................................................................................................................................................................ Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: ………………………………………………………........................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 e 76 del DPR 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenzialeDecretopresidenziale) 445/2000 for the hypothesis in false actions and declarations ................................................................................................................................................................ ................................................................................................................................................................ Luogo e data............................................. Place and date Il dichiarante The undrsigned Allegato “3” undersigned Attachment ‘3’"4" Il/la sottoscritto/a nato/a a il I, the undersigned born in on in relazione all’incarico di : In relation to the position: ❏ Di non svolgere incarichi, né di avere titolarità di cariche in Enti di diritto privato regolati o finanziati dalla Pubblica Amministrazione, né di svolgere attività professionali; ❏ Not to carry out any assignments or professional activities and not to hold positions in private law entities governed or financed by the public administration; ❏ Di svolgere incarichi e/o avere titolarità di cariche in Enti di diritto privato regolati o finanziati dalla PubblicaAmministrazione e/o di svolgere attività professionali. In tal caso specificare : ❏ To carry out assignments or professional activities and not to hold positions in private law entities governed or financed by the public administration. Please, specify: Cariche/Incarichi/attività professionali Positions / assignments / professionalactivities Ente / Società Institution / Corporation Data inizio Start date Data fine End date Il/la sottoscritto/a si impegna, altresì, a comunicare tempestivamente eventuali variazioni del contenuto della presente dichiarazione e a rendere nel caso, una nuova dichiarazione sostitutiva. The undersigned will promptly notify any variations and provide a new declaration of certification, if necessary. Camerino,

DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI. (art. 46 del DPR 445 del 28.12.2000) Substitutive declaration of documents (art. 46 of DPR 445 of 28.12.2000) Il sottoscritto The undersigned COGNOME........................................................................................................................................... (per le donne indicare il cognome da xxxxxx) NAME (Married women must indicate: spinster’s name NOME.................................................................................................................................................... Surname CODICE FISCALE................................................................................................................................ Fiscal Code NATO A...............................................PROV........................... IL....................................................... Place of birth Country Date of birth SESSO........................... Sex ATTUALMENTE RESIDENTE A........................................................PROV..................................... Place of residence INDIRIZZO...................................................................................C.A.P.............................................. Address Zip code TELEFONO: PREFISSO............................................NUMERO......................................................... Telephone number consapevole delle responsabilità penali previste dagli artt.75 e 76 del DPR 445/2000 per le ipotesi di falsi atti e dichiarazioni mendaci. Aware of the criminal liabilities with reference to art. 75 and 76 of the Presidential Decree (Decreto presidenziale) 445/2000 for the hypothesis in false actions and declarations ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ Luogo e data............................................. Place and date Il dichiarante The undrsigned Allegato “3” Attachment ‘3’