Transcript SCHEDA ISCRIZIONE/AGGIORNAMENTO AIRE (Anagrafe degli

to: Italian Consulate General in Montreal (tel. +1 514 849-8351)
CHANGE OF ADDRESS FORM (only for citizens ALREADY registered with the Italian Consulate General in
Montreal; if moving from Italy or from another Consulate/Embassy MUST use “AIRE Application Form”)
This personal declaration, given in accordance with articles 46 and
47 of D.P.R. n. 445/2000, does not require signature authentication.
a. APPLICANT
The undersigned Italian citizen:
1.
PLEASE PRINT
Given name/s
2.
Born in
3.
New address
on
Place of birth (city, province/territory/state, country)
Apt/Unit
Street no.
Postal code
Tel. home
5.
Marital status
/
 
F
M
/
dd/mm/yyyy
Street name
City
4.
Sex
Last name
Tel. work
Province/territory
Cellular
Email
 single  common law  civil union  married  separated  divorced  widow/er
b. FAMILY MEMBERS LIVING AT SAME ADDRESS (ITALIANS AND/OR OF OTHER NATIONALITY)
Given name/s
Last name
Date of birth
Sex
(*)
/
/
F M
Child 1
/
/
F M
Child 2
/
/
F M
Child 3
/
/
F M
/
/
F M
Child 4
For child 5, 6 …, attach an additional sheet.
dd/mm/yyyy
(*) Spouse, civil union partner, common law partner
c. ATTACHED DOCUMENTATION (piece of I.D. is mandatory)
 Passport (pages with picture and signature)
 Other: ______________________________________
 Provincial driver licence (front + back)
I, the undersigned, fully aware that untruthful statements, forgery and use of false documents, will be prosecuted by law as per article 76 D.P.R. n. 445/2000,
hereby declare that the above information is accurate and true. I hereby also declare to be fully aware that the personal data collected will be used, including in
its digital form, exclusively for the purpose for which this application is submitted, in accordance with D.Lgs n. 196/2003.
Place and date: __________________________ , ____ /___ /______ Signature  ___________________________________
dd/mm/yyyy
This application -with all its required documentation- can be delivered in person to the Italian Consulate in Montreal, 3489 Drummond
(corner Dr. Penfield - Metro green line, Peel stop – Bus 144), or can be forwarded by:
Post
3489 Drummond, Montreal, QC - H3G 1X6 - CANADA
Fax
+1 514 499-9471
Email (total size 5MB max)
[email protected]
For official use only
CIC / ALL.
 SÌ  NO
Firma dell’impiegato incaricato
CGIM–M010 DEM EN (R02)
MATR./UNIONE CIV.
 SÌ  NO
NASCITA
__________________________________________
Disponibile anche in italiano (CGIM–M010 DEM IT)
Aussi disponible en français (CGIM–M010 DEM FR)
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1 2 3 4  SÌ
1 2 3 4  NO
DIVORZIO
Data
 SÌ  NO
_____ / _____ / __________
@ItalyinMontreal