Mandatory fields are marked with an asterisk.
In application of the legal provision on self-certification and aware of obligation and sanction under art. 76 of D.P.R. 445 dated 28.12.2000, which I could be subject to in the case of misrepresentation, and aware in particular of the punishments for false attestations and misrepresentation under Artts. 483, 495 and 496 of the Italian Criminal Code, under my personal responsibility as provided in Art. 48, paragraph 25 of Act n° 326 dated 24.11.2003