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In compliance with the Italian Legislative Decree no. 196 dated 30/06/2003, I hereby authorize the recipient of this document to use and process my personal details and I confirm to be informed of my rights in accordance to art. 7 of the above mentioned decree -

 
.: Rosario Bellante, Via Garibaldi 70 - 51016 - Montecatini Terme (PT) - tel. 340/7846505 :.