Self-Declaration Affidavit (According To Art. 47 And Art.19 Of D.p.r. N. 445/2000) printable pdf download

Self-Declaration Affidavit (According To Art. 47 And Art.19 Of D.p.r. N. 445/2000)

Self-declaration affidavit (Dichiarazione sostitutiva dell’atto di notorietà)

(according to art. 47 and art.19 of D.P.R. n. 445/2000)

I, the undersigned (Name)____________________________________ (Surname)_________________________

Place of birth (Town/State) _________________________________________________________________

Date of birth (dd/mm/yy) _________________________________________________________________

Nationality _____________________________________________________________________________

Gender _______________

Permanent residence address (number/street/town/postal code/Country)

_________________________________________________________________________________________

Email address: _________________________________________________________________________

aware of the consequences of making false statements, falsehood of acts and use of false facts, punishable by law

according to art. 76 D.P.R. n. 445/2000 and art. 496 of the Italian Penal Code, under my own responsibility

DECLARE

____________________________________________________________________________________________;

____________________________________________________________________________________________.

Date

SIGNATURE

__________________, lì

_____________________

____________________________________

Self-certifications must be signed by the candidate in presence of a public official committed to the receipt of the

documentation. If the documentation is sent through post mail or delivered by means of other individuals, self-certifications

must be signed by the candidate and accompanied by a photocopy of each face of a valid pictured identity document.

Self-Declaration Affidavit (According To Art. 47 And Art.19 Of D.p.r. N. 445/2000)