ALLEGATO E
                          ALL'UFFICIO DEL COMUNE DI
                       _______________________________
BOLLA DI CONSEGNA DELLE DICHIARAZIONE DA PARTE DEI CENTRI AUTORIZZATI
       DI ASSISTENZA FISCALE ALLE IMPRESE E DEI PROFESSIONISTI
                                                     _______________
                                                    |               |
                  MITTENTE        ANNO DI IMPOSTA   | 1 | 9 |   |   |
                                                    |___|___|___|___|
 ___________________________________________________________________
|          |          _____________________              _________  |
|          | CODICE  |                     | IDENTIFI-  |         | |
|          | FISCALE |_|_|_|_|_|_|_|_|_|_|_| CATIVO     |_|_|_|_|_| |
|          |                                 C.A.A.F.               |
| C.A.A.F. |                                                        |
|          | DENOMINAZIONE                                          |
|          |  ____________________________________________________  |
|          | |                                                    | |
|          | |____________________________________________________| |
|__________|________________________________________________________|
|          |          _______________________________               |
|          | CODICE  |                               |              |
|          | FISCALE |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|              |
|          |                                                        |
| PROFES-  | COGNOME                          NOME                  |
| SIONISTA |  ______________________________   ___________________  |
|          | |                              | |                   | |
|          | |______________________________| |___________________| |
|__________|________________________________________________________|
|          |                                                        |
|          | COMUNE                                       PROV.     |
|          |  __________________________________________   _______  |
|          | |                                          | |       | |
| DOMICILIO| |__________________________________________| |___|___| |
|  FISCALE |                                                        |
|          | INDIRIZZO                                  C.A.P.      |
|          |  ________________________________________   _________  |
|          | |                                        | |         | |
|          | |________________________________________| |_|_|_|_|_| |
|__________|________________________________________________________|
                        DESCRIZIONE FORNITURA
                                    _____
                                   |     |
TIPO MODELLO (740, 750, 760, 770)  |_|_|_|
           COGNOME E NOME O DENOMINAZIONE DEI DICHIARANTI
 ___________________________________________________________________
|    |                           |    |                             |
| 1  |                           | 11 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 2  |                           | 12 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 3  |                           | 13 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 4  |                           | 14 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 5  |                           | 15 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 6  |                           | 16 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 7  |                           | 17 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 8  |                           | 18 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 9  |                           | 19 |                             |
|____|___________________________|____|_____________________________|
|    |                           |    |                             |
| 10 |                           | 20 |                             |
|____|___________________________|____|_____________________________|
DATA ___________                  FIRMA _____________________________
_____________________________________________________________________
PER RICEVUTA
            L'UFFICIO DEL COMUNE DI _________________________________
                           TIMBRO
                          _________
DATA ___________         |         |   FIRMA ________________________
                         |_________|