DICHIARAZIONE SOSTITUTIVA DI CERTIFICAZIONE

(Art.2, Legge 4.1.1968 n° 15 - Art.3, c.10, L. n° 127/1997)

Il/La sottoscritto/a ____________________________________________________________

Nato a ____________________________________________ Il _______________________

Residente in _________________________, via _________________________ n° ________

DICHIARA

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Quartu Sant'Elena, il _______________________
     
     
     
     
                                               IL/LA DICHIARANTE
                                                
                                                
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