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Fiscalenato a il residente ain Via nr TelDocumento di riconoscimento nrrilasciato da il  % in qualit di (soggetto interessato/legittimato/delegato)% in qualit di Consigliere Comunale del Comune di Zero Branco C H I E D E % di prendere visione% il rilascio di copia non autentica, in carta semplice% il rilascio di copia conforme all originale, in bollo. dei seguenti documenti (specificare, se conosciuti, oggetto e data del documento, autorit che ha emanato il documento, ulteriori elementi di identificazione): La presente istanza giustificata dai seguenti motivi (specificare linteresse diretto, concreto e attuale) Allega al presente modulo la seguente documentazione: Il richiedenteData, Dichiaro di aver ricevuto/visionato quanto richiesto Data Firma Riservato allUfficio: Costi di riproduzione Costi di ricerca e visura Costi per bollo Totale da rimborsare Ai sensi del Decreto Legislativo 30.06.2003, n.196, si informa che i dati personali contenuti nel presente modulo saranno trattati unicamente per le finalit inerenti allapplicazione della disciplina sul diritto di accesso. 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