SELF-CERTIFICATION of AntiMafia communication and information.docx
DOCX document 26 KB Posted
- Solicitation number
- N6817126QN087
About this file
This file contains two self-certification forms regarding anti-mafia compliance required under Italian Legislative Decree 06/09/2011 n.159. The forms are templates for declaring that the signatory and, where applicable, cohabiting family members aged 18 or older, are not subject to prohibitions, forfeitures, or suspensions under Article 57 or Article 67 of the referenced decree. Each form requires the signatory to provide personal identification information including name, date and place of birth, fiscal code or VAT number, and residential address, along with a copy of the identity document. The declarations must be signed and dated, with explicit acknowledgment of criminal liability for false statements under Presidential Decree 445 of 28 December 2000.
These self-certification forms do not require notarization and serve as replacements for standard certifications typically required by public administrations and public service managers. The forms also include a data privacy notice referencing Legislative Decree No. 196/2003, informing signatories that personal data will be processed only for the specific procedure for which the declaration is made. While included as attachments to the Chapel Sound System Upgrade and Maintenance solicitation (N6817126QN087) for Naval Supply Systems Command at NSA Naples, Italy, these forms appear to be standard Italian anti-mafia compliance documentation that may be required from contractors operating in Italy.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| intranetcontrollmachine.jpg | JPG image | |
| Chapel sound drawings.pdf | ||
| video output line.jpg | JPG image | |
| screen main room.png | PNG image | |
| EPSON2000ANSIMAINROOM.png | PNG image | |
| Solicitation N6817126QN087 Amendment 0002.pdf | ||
| Solicitation N6817126QN087 Amendment 0001.pdf | ||
| Solicitation - N6817126QN087.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
SELF-CERTIFICATION OF THE ANTI-MAFIA COMMUNICATION
(Art. 85 of Legislative Decree 06/09/2011 n.159)
The undersigned (Last name, Name) ______________________________________________________________
| Date and place of Birth | FISCAL CODE or VAT Number | Place of residence | Prov. | |
| Street_____________________________________________________________________ | n•_____________ |
Fully aware of the criminal liability faced, pursuant to and by effect of articles 75 and 76 of the Presidential Decree 28 December 2000, n• 445, in case of false declarations or creation, exhibition or use of false documents, or documents containing data no longer corresponding to the truth, declares and attests under his/her own responsibility:
That the causes of prohibition, forfeiture or suspension pursuant to art. 57 of Legislative Decree 06/09/2011 n• 159 are not present.
The undersigned also declares to be fully informed, pursuant to Legislative Decree No. 196/2003 (Code regarding the protection of personal data), that the data collected will be processed, even with IT tools, exclusively within the purpose of the procedure for which this declaration is made.
Date
Signature
Provide copy of the Identity document of the subscriber.
This declaration does not require the authentication of the signature and replaces, for all the intents and purposes, the normal certifications required by a Public Administration, as well as for managers of public services and the private sector who allow it.
Legislative Decree 06/09/2011 n. 159, art. 85 https://def.finanze.it/DocTribFrontend/decodeurn?urn=urn:doctrib::DLG:2011-09-06;159_art85
Attachment 1
SELF-CERTIFICATION OF THE ANTI-MAFIA INFORMATION
(Art. 85 of Legislative Decree 06/09/2011 n.159)
The undersigned (Last name, Name) ______________________________________________________________
| Date and place of Birth | FISCAL CODE or VAT Number | Place of residence | Prov. | |
| Street_____________________________________________________________________ | n•_____________ |
Fully aware of the criminal liability faced, pursuant to and by effect of articles 75 and 76 of the Presidential Decree 445 of 28 December 2000, in the event of false declarations or the formation, exhibition or use of false documents, or documents containing data that no longer correspond to the truth, declares and attests under his/her own responsibility:
That are no causes of prohibition, forfeiture or suspension pursuant to art. 67 of Legislative Decree 06/09/2011 No. 159, for the undersigned and/or cohabiting family members aged 18 or more (whose data are made available below).
| FIRST NAME |
| LAST NAME |
| Date of Birth |
| Place of Birth |
| Fiscal Code |
The undersigned also declares to be fully informed, pursuant to Legislative Decree No. 196/2003 (Code regarding the protection of personal data), that the data collected will be processed, even with IT tools, exclusively within the purpose of the procedure for which this declaration is made.
Date
Signature
Provide copy of the Identity document of the subscriber.
This declaration does not require the authentication of the signature and replaces, for all the intents and purposes, the normal certifications required by a Public Administration, as well as for managers of public services and the private sector who allow it.
Legislative Decree 06/09/2011 n. 159, art. 85 https://def.finanze.it/DocTribFrontend/decodeurn?urn=urn:doctrib::DLG:2011-09-06;159_art85
Attachment 2
File details come from the government source that posted it. Updated .