PIANO PULLMAN
Self-executed certification
(Art. 47 of the Presidential Decree nr. 445 dated 28 December 2000)
Bus fleet
NAME
SURNAME
BORN IN
PROV.
ON
RESIDENT IN
/
/
PROV.
IN
NR
TElEPHONE
POSTCODE
E-MAIL
TAXCODE
ID DOC
ISSUED BY
IN THE POSITION OF*
FOR**
OFFICES IN
POSTCODE
NR
TElEPHONE
FAX/CELL.
PEC
TAXCODE
VAT REGISTRATION NR
(*) Legal representative / (**) Company, sole proprietorship etc
DECLARES
IN ORDER TO BE INCLUDED IN OUR DATABASE
New Bus
PUllMAN-006 agg. 29032016
Registration plate numberLicence
Variation Data
Anti-pollution parameterLength
The undersigned, aware of the civil and penal responsibilities set out in article 76 of the Presidential Decree nr 445 dated 28 December 2000 and in articles 495 and 496 of the Penal
Code in the event of false or misleading certifications or declarations, confirms that everything declared above corresponds to the truth. The undersigned also undertakes to immediately
inform Roma Servizi per la Mobilità S.r.l. of any variation to the content of the declaration.
He/she also declares that the vehicle was not acquired with public funding that all national enterprises cannot benefit from.
The following documents are enclosed:
Copy of logbook
•
Copy of temporary registration
•
Copy of ID document
Rome
Signature
The undersigned, pursuant to the legislative decree nr. 196/03, consents to the handling of personal details exclusively for the carrying out of the services by Roma Servizi per la
Mobilità S.r.l.
Rome
Signature
PULLMAN-006
Declaration without signature authentication pursuant to article 21 paragraph 1 and article 38 paragraph 3 of the Presidential Decree nr. 445 dated 28 December 2000.
Stamp-duty free declaration, pursuant to article 37 of the Presidential Decree nr. 445 dated 28 December 2000.