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

pursuant to Articles 46, 47 and 38 of Presidential Decree No. 445 of 28.12.2000, 
 (check the appropriate box and fill in all the sections)

to be in possession of the following degree: 
(specify if it is laurea V.O. before 1999, or laurea specialistica DM 509/99, or laurea magistrale DM 270/04)
qualifications: _________________________________________________________________ obtained at: ___________________________________________________________________ on ___________________________ with the grade of: ________________________________

to achieve the degree within 31/10/2020
(specify if it is laurea specialistica DM 509/99, or laurea magistrale DM 270/04)
qualifications: _________________________________________________________________
University:___________________________________________________________________ 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).

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

Course Title	Mark/Out of	Date	

			

……………………………………………………………………..……………………..

to be in possession of the following laurea triennale
(if required in Annex 3)
qualifications: _________________________________________________________________ obtained at: ___________________________________________________________________ on ___________________________ with the grade of: ________________________________

 the following list of examinations completed for laurea triennale 
(if required in Annex 3)

Course Title	Mark/Out of	Date	

			

……………………………………………………………………………………………..
Pursuant to Articles 47, 38 and 19 of Presidential Decree No. 445 of 28.12.2000, declare that the photocopies relating to the qualifications attached to the application (publications, certifications, degree, etc.), conform to the originals.
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)