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010101010101010101010101010b030a0c090a090a0a04050c0c0c0c0f0c010310101010100c01070c111010100f050512090d0d091209040701010101010101 0101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101020e040c0c0a090a050509090909 0a0602060c0c0c0c0c0c040b0c0c0a0909090504090d0a0a09040e01010101010101010101010101010101010101010101010101010101010101010101010101 010101010101010101010101010101010101010101010101010801040c050805090a090509050205090909090d09050709090909090d0d0e0909080b0b010101 01010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010102 08010206050805090a05010609090605090905070a09060803060401080b01010101010101010101010101010101010101010101010101010101010101010101 01010101010101010101010101010101010101010101010101010101010101010101010101010102010101030402020405040202040604010304070101070201 01010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101 01010101010101010101010101010101010101010101010101020101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010101010c00000040092900aa000000000000009000640000000000040000002701ffff030000000000}}}{\rtlch\fcs1 \af36 \ltrch\fcs0 \insrsid4802498\charrsid10233447 \par }{\rtlch\fcs1 \af36 \ltrch\fcs0 \insrsid4802498 COMUNE DI BANARI - PROVINCIA DI SASSARI \par }\pard\plain \ltrpar\s19\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4802498 \rtlch\fcs1 \af37\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1040\langfe1033\cgrid\langnp1040\langfenp1033 {\rtlch\fcs1 \af37\afs20 \ltrch\fcs0 \fs20\insrsid4802498\charrsid7234831 PIAZZA A. SOLINAS N. 1 07040 BANARI (SS) \par TEL.079/826001- FAX 079/826233 P.IVA 00257710905 \par }\pard \ltrpar\s19\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7234831 {\rtlch\fcs1 \af37\afs20 \ltrch\fcs0 \fs20\insrsid4802498\charrsid7234831 e-mail:comunebanari@tiscali.it \par }\pard\plain \ltrpar\s16\qc \li0\ri0\sb180\sl285\slmult1\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-6\expndtw-30\insrsid3279934 DICHIARAZIONE DI VOLONT\'c0 ALLA DONAZIONE DI ORGANI E TESSUTI \par }\pard\plain \ltrpar\s17\ql \li0\ri0\sb216\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid3279934 Io }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid4802498 S}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid3279934 ottoscritto/a (cognome)}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid4802498 ___________________________________________________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid3279934 \par }\pard \ltrpar\s17\ql \li0\ri0\sb180\sl216\slmult1\nowidctlpar\tqr\tlul\tx8899\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 (n}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid4802498 o}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 me) \tab }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid3279934 sesso F M \par }\pard \ltrpar\s17\ql \li0\ri0\sb180\sl208\slmult1\nowidctlpar\tlul\tx1968\tx6312\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4802498 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-5\expndtw-28\insrsid3279934 na}{ \rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-5\expndtw-28\insrsid4802498 t}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-5\expndtw-28\insrsid3279934 o/a il\tab }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-5\expndtw-28\insrsid4802498 ____________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 a}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid4802498 _________________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd0\expndtw-2\insrsid3279934 Prov.}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd0\expndtw-2\insrsid4802498 ____________ \par }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-3\expndtw-16\insrsid3279934 Na}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-3\expndtw-16\insrsid4802498 z}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-3\expndtw-16\insrsid3279934 ionalit\'e0 }{ \rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-3\expndtw-16\insrsid4802498 _________________________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid3279934 codice fiscale}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid4802498 _____________________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-14\insrsid3279934 \par }\pard \ltrpar\s17\ql \li0\ri0\sb216\sl211\slmult1\nowidctlpar\tqr\tlul\tx7551\tqr\tlul\tx8899\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-10\insrsid3279934 res}{ \rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-10\insrsid4802498 ide}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-2\expndtw-10\insrsid3279934 nte a \tab }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd0\expndtw-2\insrsid3279934 Prov.\tab }{ \rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 \par }\pard \ltrpar\s17\ql \li0\ri0\sb180\sl208\slmult1\nowidctlpar\tx6922\tqr\tlul\tx8899\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid4802498 Via___________________________________________N._________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 \tab }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-1\expndtw-6\insrsid3279934 cap.\tab }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 \par }\pard \ltrpar\s17\ql \li0\ri0\sb216\sl211\slmult1\nowidctlpar\tqr\tlul\tx4042\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-4\expndtw-22\insrsid3279934 A.S.}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-4\expndtw-22\insrsid4802498 L}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-4\expndtw-22\insrsid3279934 . di appartenenza}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-4\expndtw-22\insrsid4802498 ________________________________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-4\expndtw-22\insrsid3279934 \tab }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\insrsid3279934 \par }\pard\plain \ltrpar\s16\qc \li0\ri0\sb144\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\expnd0\expndtw3\insrsid3279934 dic}{\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\expnd0\expndtw3\insrsid4802498 hi}{\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\expnd0\expndtw3\insrsid3279934 aro la mia volont\'e0 alla donazione di organi e tessuti dopo la morte a scopo di \par }\pard \ltrpar\s16\ql \li0\ri0\sb36\sl196\slmult1\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\insrsid3279934 trap}{\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\insrsid4802498 i}{\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\insrsid3279934 a}{\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\insrsid4802498 n}{\rtlch\fcs1 \ab\af0\afs25 \ltrch\fcs0 \b\fs25\insrsid3279934 to. \par }\pard \ltrpar\s16\ql \fi720\li5760\ri0\sb216\sl194\slmult1\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin5760\itap0\pararsid13449458 {\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-2\expndtw-12\insrsid13449458 Firma}{\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-2\expndtw-12\insrsid3279934 \par }{\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-2\expndtw-12\insrsid9709548\charrsid13449458 \par }\pard\plain \ltrpar\qj \li0\ri0\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13255151 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang1024\langfe1024\noproof\insrsid6227892 {\shp{\*\shpinst\shpleft5242\shptop11\shpright8387\shpbottom11\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr2\shpwrk0\shpfblwtxt0\shpz0\shplid1026 {\sp{\sn shapeType}{\sv 20}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn shapePath}{\sv 4}}{\sp{\sn fFillOK}{\sv 0}}{\sp{\sn fFilled}{\sv 0}}{\sp{\sn lineWidth}{\sv 12065}}{\sp{\sn fArrowheadsOK}{\sv 1}}{\sp{\sn dxWrapDistLeft}{\sv 0}} {\sp{\sn dxWrapDistRight}{\sv 0}}{\sp{\sn dhgt}{\sv 251658240}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fBehindDocument}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8192\dpline\dpptx0\dppty0\dpptx3145\dppty0 \dpx5242\dpy11\dpxsize3145\dpysize0\dplinew19\dplinecor0\dplinecog0\dplinecob0}}}}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13255151\charrsid7234831 }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13449458 \par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13255151\charrsid7234831 La manifestazione del consenso o del diniego alla donazione costituisce una facolta\rquote e non un obbligo il relazione all\rquote acquisizione da parte di questo ufficio della dichiarazione di volonta\rquote in merito alla donazione degli organi e tessuti, secondo quanto previsto dall\rquote art. 3 comma 8 bis L. 26.02.2010 N. 25 e s.m.i.}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7234831\charrsid7234831 }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13255151\charrsid7234831 La Informiamo di quanto segue: \par Il titolare del trattamento e\rquote il Comune di Banari; \par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 Il Responsabile del trattamento e\rquote il Signor Carta Giuseppe;}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13255151\charrsid7234831 \par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 La raccolta e il trattamento del dato avverra\rquote nel rispetto del d.Lgs N. 196/2003 per gli scopi e le finalita\rquote previste dalla normativa in materia di prelievo e trapianti d\rquote organi e tessuti. \par Il dato relativo alla dichiarazione di volonta\rquote verra\rquote custodito su archivi cartacei e informatici attraverso idonee misure di sicurezza, e sara\rquote trasmesso per via telematica ai Centri di Coordinamento }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7234831\charrsid7234831 Regionali }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 e al Centro Nazionale per i }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7234831\charrsid7234831 T}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 rapianti esclusivamente per gli scopi e le finalita\rquote previste dalla normativa vigente in materia di trapianti ed ogni ulteriore informazione potra\rquote essere acquisita collegandosi all \rquote indirizzo http//www.trapianti.salute.gov.it. \par L\rquote eventuale modifica della decisione presa in questa sede in merito alla donazione potra\rquote avvenire in ogni momento presso l\rquote ufficio preposto della ASL di appartene}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 n}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 za, le Aziende ospedaliere, gli ambulatori del medici di medicina gen}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 e}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 rale}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7234831\charrsid7234831 ,}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7234831\charrsid7234831 i}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9709548 C}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 omuni al momento del rinnov}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 o}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 della carta identi}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 t}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 a\rquote , i Centri Regionali dei }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7234831\charrsid7234831 T}{ \rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 rapianti, o con una dichiarazione su moduli gia\rquote predisposti da enti pubblici o Associazione dei donatori, o con una dichiarazione, resa in carta libera, da cui risultano, oltre alla volonta\rquote in}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 ordine alla donazione degli organi i dati pers}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 o}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 nali , la data e la firma}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2105124\charrsid7234831 . \par Con riferimento ai dati qui raccolti, ha diritto, ai sensi dell\rquote art. 7 del D.Lgs. N. 196/2003,ad ottenere ogni modifica, rettifica, integrazione, cancellazione o aggiornamento, rivolgendosi all\rquote Amministrazione medesima.}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8198082\charrsid7234831 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7234831 \tab \tab \tab \tab \tab \tab \tab \tab \tab FIRMA \par \tab \tab \tab \tab \tab \tab \tab ________________________________ \par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid7234831\charrsid8198082 \par }\pard\plain \ltrpar\s16\qc \li0\ri0\sb324\sl204\slmult1\nowidctlpar\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-6\expndtw-34\insrsid3279934 ALL'UFFICIO ANAGRAFE DEL COMUNE DI }{\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-6\expndtw-34\insrsid7234831 BANARI}{\rtlch\fcs1 \af39 \ltrch\fcs0 \f39\expnd-6\expndtw-34\insrsid3279934 \par }\pard\plain \ltrpar\s17\ql \li0\ri0\sb180\nowidctlpar\tlul\tx6418\tqr\tlul\tx7363\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7234831 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-1\expndtw-9\insrsid5580358 Attesto che la presente dichiarazione e\rquote stata resa e sottoscritta in mia presenza dal dichiarante sopra generalizzato identificato mediante______________________________}{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-1\expndtw-9\insrsid3279934 }{\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-1\expndtw-9\insrsid3279934\charrsid5580358 \par }\pard \ltrpar\s17\ql \li0\ri0\sb180\sa144\sl204\slmult1\nowidctlpar\tqr\tx9072\wrapdefault\nocwrap\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13449458 {\rtlch\fcs1 \af39 \ltrch\fcs0 \cs18\f39\expnd-4\expndtw-20\insrsid5580358 ________________________________________________________.}{\rtlch\fcs1 \af39 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