Subject: payment modalities for traceability of financial flows.
Name Surname/Company name
The undersigned………..……………………………………….……………………………………..
Place of birth ……………………………………………… Date of birth……………………………
Resident of …...………………………………………………………………………………………..
Address………………………………..…………………. Post Code………………………………...
Tax Code………………………………………………………………………………………………
As the ………………………………………………………………………………………………….
For the Company……………………………………………………………………………………....
With legal headquarter in …………………………….. Address …………………………………….
Tax code …………………………………… VAT number ………………..….……………………..
In relation to art. 3 (traceability of financial flows) of Law 136/2010 demands that the payment must be done on a bank
or postal account dedicated, even if not in an exclusive way, to the financial transactions concerning works, services
and provisions of public orders, according to the following mode:
By credit on bank or postal account n° …………………..……………………………………………
Bank ………………………………………… Branch …………………………………………...
Address …………………………………………………………………………………………..
BANK ACCOUNT DETAILS – IBAN CODE
IBAN Code
Personal details and tax code of the natural persons appointed to act on it:
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
Name ………………………………… Surname ……………………………………………….
Place of birth ………………….. Date of birth ………………… Tax Code ……………………
Charge (ex. President, Director, Associate etc.) ………………………………………………….
The undersigned moreover undertakes to communicate possible variations regarding the above information.
Signature
………………………………….
Attachment: Photocopy of identity card