FEA Revocation

DECLARATION OF REVOCATION OF ACCEPTANCE

FEA TERMS OF SERVICE

I, the undersigned, Surname___________________Name____________________

Date of birth ____/____/_________

Tax Code____________________________

PEC or email address ________________________________________________

I hereby notify you of my withdrawal from the Advanced Electronic Signature Service provided by

.

_______________________________________________________

I hereby declare that I am aware that as a result of this notice of revocation, any further

The signing of documentation will take place in paper form until a possible new subscription.

The withdrawal of membership will be effective upon receipt of this form.

Date of Signature

________________ ___________________________