SELF CERTIFICATION of AntiMafia communication and information EN version.docx
DOCX document 26 KB Posted
- Attached to
- OFFICE FURNITURE FOR NSA NAPLES (CMDCM OFFICE)
- Solicitation number
- N6817126QN059
About this file
This file is a template for Italian anti-mafia self-certification declarations required under Article 85 of Italian Legislative Decree 06/09/2011 n. 159. The document provides two separate certification forms that signatories must complete to confirm their compliance with anti-mafia regulations.
The first certification form requires the undersigned to declare that they do not meet the causes of prohibition, forfeiture, or suspension outlined in Article 57 of the legislative decree. The second certification form (Attachment 1) extends the declaration to include the undersigned and all cohabiting family members aged 18 or older, requiring detailed information such as first name, last name, date of birth, place of birth, and fiscal code for each individual. Both forms require the signatory to acknowledge criminal liability for false declarations under Presidential Decree 445 of December 28, 2000, and to provide a copy of the signatory's identity document. The declarations do not require signature authentication and serve as replacements for standard certifications typically required by public administrations and public service managers. Both forms include notice regarding data processing under Italian Legislative Decree No. 196/2003 (personal data protection code). This template is associated with a Department of the Navy Naval Supply Systems Command solicitation (N6817126QN059) for office furniture procurement for the NSA Naples CMDCM office, though the anti-mafia certification itself is a standalone Italian regulatory requirement rather than a document specific to the furniture solicitation requirements.
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| Solicitation - N6817126QN059.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 .