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(_______) il ________________________ \par - \'e8 cittadino italiano altro (indicare quale) ______________________________________________ \par - \'e8 residente a _____________________________}{\f1\insrsid6562393 ______________________________________}{\f1\insrsid6911994 _ (Prov._____) }{\f1\insrsid6562393 \par }{\f1\insrsid6911994 in Via/Piazza ___________________}{\f1\insrsid6562393 _________________________________________}{\f1\insrsid6911994 _}{\f1\insrsid6562393 __}{\f1\insrsid6911994 ______}{\f1\insrsid6562393 N\'b0 _______}{\f1\insrsid6911994 \par }\pard \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\f1\insrsid6911994 telefono ___________________________}{\f1\insrsid6562393 cellulare____________________________ ;}{\f1\insrsid6911994 \par \par }{\f1\cf1\insrsid6911994 - proviene dalla scuola _______________________________________ ove nell'a.s. ______________________ \par \par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\f1\insrsid6911994 }{\f1\cf1\insrsid6911994 frequenta o ha frequentato la classe_____ ____sez.__________specializzazione_______________________ \par }{\f1\insrsid6911994 - lingua/e straniera/e studiata/e: ________________________________________________________________}{\f1\cf1\insrsid6911994 \par }\pard \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\f1\cf1\insrsid6911994 - che la propria famiglia convivente \'e8 composta da: \par }\pard \ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\cf1\insrsid6911994 _________________________________ ______________________________________ ____________________________ \par }\pard \ql \li0\ri0\sl65\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\cf1\insrsid6911994 _________________________________ ______________________________________ ____________________________ \par _________________________________ ______________________________________ ____________________________ \par _________________________________ ______________________________________ ____________________________ \par _________________________________ ______________________________________ ____________________________ \par _________________________________ ______________________________________ ____________________________ \par }\pard \ql \li0\ri0\sl360\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\f1\fs16\cf1\insrsid6911994 Cognome e nome luogo e data di nascita Relazione di parentela \par }{\f1\fs18\cf1\lang1024\langfe1024\noproof\insrsid6911994 {\shp{\*\shpinst\shpleft4807\shptop214\shpright5091\shpbottom498\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz15\shplid1043 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8207\dprect\dpx4807\dpy214\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft4127\shptop214\shpright4411\shpbottom498\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz16\shplid1044{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8208\dprect\dpx4127\dpy214\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs16\cf1\insrsid6911994 \par }{\f1\fs18\cf1\insrsid6911994 - \'e8 stato sottoposto alle vaccinazioni obbligatorie si no}{\f1\cf1\insrsid6911994 \par }\pard \ql \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 {\fs18\cf1\insrsid6911994 }{\f1\fs18\cf1\insrsid6911994 - il reddito imponibile del nucleo familiare }{\b\f1\fs18\cf1\insrsid6911994 (rilevabile dall'ultima dichiarazione dei redditi) }{\f1\fs18\cf1\insrsid6911994 \'e8 di }{\b\f1\fs28\cf1\insrsid6911994 \'80}{\f1\fs18\cf1\insrsid6911994 _______________________ \par }\pard \qj \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 {\f1\fs18\cf1\insrsid6911994 }{\i\f1\fs18\cf1\insrsid6911994 (}{\i\f1\fs16\cf1\insrsid6911994 Dichiarazione da rilasciare solo ove ricorrano le condizioni per usufruire dell'esonero delle tasse scolastiche o di altre agevolazioni previste). \par }\pard \qj \li10\ri0\nowidctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin10\itap0 {\b\f1\fs18\cf1\insrsid6911994 L\rquote ESONERO NON E\rquote PREVISTO PER LA TASSA \'93CONTRIBUTI VARI\'94 \par }\pard \qj \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 {\i\f1\fs16\cf1\insrsid6911994 \par }\pard \qj \li10\ri0\sl480\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 {\f1\fs18\cf1\insrsid6911994 ALLEGA: \par }{\f1\fs18\cf1\lang1024\langfe1024\noproof\insrsid6911994 {\shp{\*\shpinst\shpleft147\shptop21\shpright289\shpbottom163\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz10\shplid1036 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8202\dprect\dpx147\dpy21\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs18\cf1\insrsid6911994 Ricevuta del versamento di \'80 15,13 (tassa frequenza) sul c/c 1016 intestato a: Agenzia delle entrate \endash C.O. di Pescara \par }\pard \ql \li0\ri0\sl480\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\f1\fs18\cf1\lang1024\langfe1024\noproof\insrsid6911994 {\shp{\*\shpinst\shpleft143\shptop3\shpright285\shpbottom145\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz11\shplid1037{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8203\dprect\dpx143\dpy3\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs18\cf1\insrsid6911994 Ricevuta del versamento di \'80 28,00 (contributi vari) sul c/c 15580095 intestato a I.P.I.A. "G. Ferraris" \endash Iglesias \par }\pard \ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\cf1\insrsid6911994 Data_______________________________ Firma}{\b\cf1\insrsid6911994 ______________________________________ }{\cf1\insrsid6911994 \par }{\fs18\cf1\insrsid6911994 }{\fs16\cf1\insrsid6911994 Firma di autocertificazione (Leggi 15/98 127/97 131/98) da \par sottoscrivere al momento della presentazione della domanda \par all'impiegato della scuola \par \par }\pard\plain \s17\ql \li230\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin230\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\fs16\lang1024\langfe1024\noproof\insrsid6562393 {\shp{\*\shpinst\shpleft-54\shptop69\shpright10674\shpbottom1644\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz14\shplid1040{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fFilled}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 1}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8206\dprect\dpx-54\dpy69\dpxsize10728\dpysize1575 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat0\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f0\insrsid6911994 \par \par }\pard \s17\qj \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid6562393 {\fs20\insrsid6562393 Il sottoscritto dichiara di essere consapevole che la scuola pu\'f2 utilizzare i dati contenuti nella presente \par autocertificazione esclusivamente nell'ambito e per i fini istituzionali propri della P. A.(D.Leg.vo 30 giugno 2003, n.196). \par }\pard\plain \qj \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0\pararsid6562393 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\insrsid6562393 \par }\pard \qj \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 {\f1\insrsid6911994 }{\cf1\insrsid6911994 Data_______________________________ Firma}{\b\cf1\insrsid6911994 ______________________________________}{\f1\insrsid6911994 \par }\pard \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\insrsid6911994 \par \par \par }}