REPLACEMENT STATEMENT OF CERTIFICATION (SELF-CERTIFICATION) OF DEGREE TITLE OR OF OTHER STUDY TITLES
(Article n° 46 of the Decree of the President of the Republic of the 28/12/2000 n° 445)

I, the undersigned Surname_____________________________Name______________________________ Matriculation n°____________(only for students of the International Telematic University UNINETTUNO) 
State under my own responsibility 
Being aware of the criminal penalties mentioned in article n° 76 of the Decree of the President of the Republic n° 445/2000 in case of unfaithful statements and unlawful acts, what follows:
I was born in _____________________________on the ________________________ 
I reside in ____________________________________n._____________ 
Town ___________________________________Prov. (________) Post code ___________ 
Telephone ___________________________Mobile __________________________ 
I  am a ____________________________________________  citizen
My tax payer’s number is ____________________________________________ 

I earned the following study title  _______________________________ 
Awarded in year _____________on the ______________with grade ___________ 
at (Institution’s name)__________________________________________________________ 
Town _____________________________________________Prov._______________ 
“The matriculation/enrolment in the Degree/Master’s Course is made based on the data included into the present self-certification pursuant to the Decree of the President of the Republic n° 445/00 and following amendments; if, further to an ex-officio control performed pursuant to art. n° 43 and art. n° 71 of the Decree of the President of the Republic n° 445/00, one or more data prove to be incorrect and/or untrue, without prejudice to the criminal penalties envisaged by the laws currently in force, the University may modify or cancel the matriculation/enrollment made”.
______________________________    
(Place and Date)      						 Signature  ___________________________
               (Name and Surname) 
This form must be signed in the presence of the receiving officer otherwise you must send the original duly-signed statement via PEC (Certified Electronic Post) info@pec.uninettunouniversity.net) or by registered letter with acknowledgment of receipt (Students Secretariat) enclosing a photocopy of a valid identity document. Pursuant to the Legislative Decree of the 30/06/2003, n° 196, we inform you that the submitted data will be handled in compliance with the purposes for which they were requested. 
REPLACEMENT STATEMENT (SELF-CERTIFICATION) OF CLOSING OF PREVIOUS CAREER OR REVOCATION
(Article 46 of the Decree of the President of the Republic n° 445 of the 28/12/2000)
I, the undersigned
Surname _____________________________Name______________________________
Matriculation n° ____________  (only for students of the International Telematic University UNINETTUNO)
Born in ____________________________________ on the  ________________________
Residing ____________________________________________n._____________
Town ___________________________________Prov. (________) Post Code ___________
Telephone  ___________________________Mobile __________________________
State under my personal responsibility 
Being aware of the criminal penalties mentioned in article n° 76 of the Decree of the President of the Republic n° 445/2000 in case of unfaithful statements and unlawful acts, what follows:
I am enrolled in the University  ______________________________________
Matriculation date _____________________________________________________
Study course (please write the study course name in full and the degree class)
___________________________________
That I closed my career on the _____________________
with:         □  Graduation             □   Withdrawal              □  Revocation
If graduated, please indicate grades  ______/_________

______________________________    
(Place and Date)      						 Signature ___________________________
               (Name and Surname) 
This form must be signed in the presence of the receiving officer otherwise you must send the original duly-signed statement via PEC (Certified Electronic Post) info@pec.uninettunouniversity.net) or by registered letter with acknowledgment of receipt (Students Secretariat) enclosing a photocopy of a valid identity document. Pursuant to the Legislative Decree of the 30/06/2003, n° 196, we inform you that the submitted data will be handled in compliance with  the purposes for which they were requested.