Title: Declaration instead of certification
Author: a
Last saved by: utente
Company: Hewlett-Packard Company

Replacement Declaration Form 
(Article 46 of Presidential Decree No. 445 of 28 December 2000)
and/or
Declaration form instead of the affidavit
(Article 47 of Presidential Decree No. 445 of 28 December 2000)

The undersigned……………………………………………. born in …………………… province of…….on………………….. residing at…………………….……………………………… province of ………. Zip Code…………….. Street…………………………………….. number……………

DECLARES

1)	pursuant to Articles 46, 47 and 38 of Presidential Decree No. 445 of 28.12.2000, to be in possession of the following (point out the information regarding the BSC, if required in Annex 3, and MSC degree):  
qualifications: ……………...…………..……………………………………………………….. obtained at: ……………....................................................................................................... on:…………………..…. with the grade of: ……………………….

2)	 to achieve, within 31/10/2019, the master degree .......................................... obtained at: ........................................................ and, within the beginning of the course, to submit the self-certification, result in rejection of the admission, at the Ph.D office (dottorato@unifi.it).

3)	 the following list of examinations completed (mandatory for those candidates who are not yet graduated):

Course Title | Mark/Out of | Date

4)	pursuant to Articles 47, 38 and 19 of Presidential Decree No. 445 of 28.12.2000, that the photocopies relating to the qualifications attached to the application (publications, certifications, degree, etc.), conform to the originals: 
(to be completed where the qualifications are required in Annex 3) 
a) ……………………………………………………………………………...………………….
b) ……………………………………………………………………………...………………….
c) ……………………………………………………………………………...………………….

The undersigned declares that s/he knows the penal sanctions resulting from false statements, training and/or use of false documents referred to in Article 76 of the Presidential Decree of 28.12.2000, No. 445, as well as the forfeiture of any benefits resulting from the measure of false statements prepared by Article 75 of the Presidential Decree of 28.12.2000, number 445.
The undersigned, on pain of nullity of the declaration, attaches the photocopy of a valid identity document.

Date ………………………..

								           The Declarant
								………………………………
									(readable signature)