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Pursuant to the terms and conditions of Sections 7, 13, and 23 of Legislative Decree n° 196/2003, I hereby declare that I have read the instructions given to me by Sambers Italia S.p.A., as regards the processing of my personal data, that I have been fully informed of my statutory rights and the exercise thereof, and in witness whereof I hereby set my hand and hereto

to the processing of my personal data for the purposes for which I release them as specified above.