B08-SOL_W912PF26QA056_Attachment6_SelfCertificationforAntimafiaCommunication.pdf

This is a self-certification declaration form (Dichiarazione sostitutiva di certificazione) required for federal contract opportunity W912PF26QA056, issued under Italian law (D.P.R. n. 445 del 28.12.2000). The form is an attestation template that requires completion by an authorized representative of a bidding company.

The declarant must provide personal identification information (name, tax identification number, birthplace, residence address) and company details (company name, tax identification number, registered office address). The signatory certifies under penalty of perjury that neither the individual nor the company is subject to any prohibitions, disqualifications, or suspensions under Article 67 of Legislative Decree No. 159 of September 6, 2011 (anti-mafia certification requirements). The form includes a statement acknowledging that personal data collected will be processed exclusively within the scope of the procurement procedure, in compliance with Legislative Decree No. 196/2003 regarding personal data protection. The declaration must be signed and dated by the authorized representative. This form serves as a substitute for formal anti-mafia certification documentation typically required for government contracts in Italy.