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I declare to have carefully read and expressly accept the above specific clauses

I declare to have read the above privacy information, provided by Actalis pursuant to Art. 13 of D.lgs.196/2003, and to consent to the processing of personal data for the purposes and in the manner therein specified. I also declare to be aware that, in the absence of my consent to such treatment, the provisions set forth in the above privacy information may apply