SUBSTITUTIVE DECLARATION OF CERTIFICATION
(in order to declare the conformity of a document to the original)
(art. 47 and 19 of D.P.R. 28/12/2000 n. 445)

The Undersigned ______________________________________________________
                                              (surname)                                                  (name)

born in ___________________________________(_____) on __________________
                                (place)                                            (Country)

resident in _______________________________________________________(____) 
			(place)                                                                                         (Country)     

in ___________________________________________________________________
 			(home address with street number)                                   

Under its own responsibility and aware of the criminal liability resulting from untrue statements and falsehoods in the acts, pursuant to art. 76 of Presidential Decree no. 445 of 28/12/2000;
aware, moreover, of the administrative consequences regarding the forfeiture of any benefits resulting from the measure issued on the basis of untrue statements;

DECLARES

that the following qualifications/titles produced in copy:
1.___________________________________________________________________
2.___________________________________________________________________
3.___________________________________________________________________
_____________________________________________________________________

correspond to the original.

____________________________ 	Signature ____________________________                               
              (Place and Date )