SELF CERTIFICATION of AntiMafia communication and information EN version.docx
DOCX document 26 KB Posted
- Attached to
- Office Furniture for NSA Naples
- Solicitation number
- N68171
About this file
This file is a self-certification form for anti-mafia compliance required under Italian Legislative Decree 06/09/2011 n.159. The document contains two separate certification templates that declarants must complete and sign under criminal liability, affirming awareness of the penalties for false declarations or fraudulent documents per Presidential Decree 445 of 28 December 2000.
The first certification template requires the declarant to attest that no causes of prohibition, forfeiture, or suspension exist pursuant to Article 57 of the Legislative Decree. The second certification template, titled "Self-Certification of Anti-Mafia Information," requires the declarant to provide similar attestations for themselves and any cohabiting family members aged 18 or older, with a separate data section to list family member names, dates of birth, places of birth, and fiscal codes. Both templates require the declarant to provide a copy of their identity document and include a signature block and date field. The declarations reference compliance with Legislative Decree No. 196/2003 regarding personal data protection, confirming that collected data will be processed only for the specific procurement procedure. These certifications do not require signature authentication and replace standard certifications normally required by public administrations or public service managers.
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| File | Type | Posted |
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| Solicitation - N6817126QN050.pdf | ||
| Space Layout.pdf |
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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 .