Title: ALLEGATO "A"
Author: EMADDALONI
Last saved by: CORRADO Giuliana
Company: Ca' Foscari - SIA

SELF-EXECUTED CERTIFICATE
(as per art. 46 of D.P.R. No. 445/2000)

SELF-EXECUTED AFFIDAVIT
(as per art. 47 of D.P.R. No. 445/2000)

Public selection procedure for No. 1 fixed-term researcher 

Academic recruitment field ________________________

I, the undersigned,

Surname________________________________________________________________________________________

Name __________________________________________________________________________________________

Born in __________________________________________________ Province of _____________________________

On ____________________________________________ Sex ____________________________________________

Currently resident in ___________________________________________Province of __________________________

Address ________________________________________________________ Zip code ________________________

Telephone: ________________________

Aware that making a false statement, using or drawing up false documents as per Art. 76 of D.P.R. No. 445, 28 December 2000, is a criminal offence that might render me liable to prosecution, I

DECLARE THAT:

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________

I, the undersigned, give my consent to the processing of the personal information provided for the purposes of the activities related to this selection procedure in compliance with Italian Legislative Decree No. 196/2003.

Place and date ..........................................

The Applicant
…………………………………………………