Ufficio di Registrazione

REGISTRATION AND CERTIFICATION REQUEST FORM

Remote Digital Signature

Infocert S.p.A. (hereinafter referred to as "Infocert") provides the Digital Signature Service (hereinafter referred to as the "Service"). The
company is included in the list of accredited certifiers of the Agenzia per l’Italia Digitale. When using the Service, the Holder can conclude
contracts, and, more generally, make commitments and release declarations for all purposes since the digital signature on computer
documents is equivalent to the autograph signature by law. The documents signed with the digital signature meet the written form legal
requirement in accordance with current Italian law. The digital signature is legally valid provided that, on the date of the signature of the
document, the qualified certificate issued to the Holder is not expired, revoked or suspended.
The Service, by virtue of a special agreement with Enel, is offered by Infocert to the employees of Enel until the expiry date of the relevant
contract, so as to increase the safety and the efficiency when generating and signing contracts.
The Service is carried out by Infocert through its own direct agents or through delegates of third-party companies, while Enel operates as a
"Registration Office". The contractual framework of the Service offered by Infocert to Enel operators is contained in this Request Form
(hereinafter referred to as the "Form"), in the following general terms and conditions of contract (hereinafter referred to as the "General
Conditions"), as well as in the Instructions of Use of the Digital Signature and in the ICERT-INDI-MO and ICERT-INDI-MOCA Operating
Manual (hereinafter referred to as the "Operating Manual") , available at www.firma.infocert.it (hereinafter referred to as the "Infocert
Documentation").
The undersigned Holder, whose data are indicated in the personal data box below, is interested in using the Service under the following terms
and conditions:

Tax Code (1)

(1) for foreign citizens who do not own the Italian Tax Code, the passport number must be written as follows:
PASSPORT<passport number >
Surname Name
Date of birth / / Gender M F
City of birth Region
(2)
State of birth Citizenship
(2) Not required in the case of people born in areas no longer part of the Italian territory (pursuant to Law no. 54 of February
15, 1989). In the latter case please specify "City territory ceded".
Residence:
Address
Zip
City Region Code
State
Identification document (3)
(3) foreign citizens’ passport must be valid

ID Type ID Number
Issued by on / /
E-mail address @

Choose a type of OTP reception:

Mobile phone number (for texts or software token):
Address for device delivery (for hardware token): TEXT  Hardware Token  Software Token 

Address
Zip
City Region Code
State

BY SIGNING THIS FORM THE APPLICANT

DECLARES

a) to confirm, in accordance with the D.P.R. 445/2000, the adequacy and accuracy of his/her personal data as
indicated in the box above, under his/her own personal responsibility and to be aware that in the event of false
declarations s/he will incur the penalties laid down by the Penal Code and the special laws on the subject;
b) to have digitally received, a copy of Infocert Documentation, to have read it carefully, to have understood its content
and to be aware of the contractual commitments related to the activation of the Service;

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 Ufficio di Registrazione

c) to be informed that, in the case of conclusion of the contract relating to the Service outside the commercial premises
or by means of distance techniques, s/he may terminate the contract relating to the Service within 14 working days
from the date of its conclusion, without any penalty and without specifying the reason in the manner established by the
General Conditions requesting at the same time the revocation of the certificate;
d) to accept that the contract related to the Service will be terminated automatically if, for any reason, the undersigned
Holder is no longer linked to Enel;
e) to accept the reception by email of the passphrase-encrypted envelope containing the emergency code;
f) to be informed that Infocert may withdraw from the contract related to the Service by providing the undersigned Holder
with a notice of 30 (thirty) days, unless due to a just cause;
g) to be informed and aware that the exercise of the right of withdrawal from the contract related to the FD Service will
also be understood as an express request for revocation of the releted certificate. Similarly, any request for revocation
of the digital signature certificate is for all purposes the exercise of the withdrawal from the FD Service contract.

Based on the above confirmed and stated, the undersigned Holder REQUESTS Infocert:

- to use the Service provided by Infocert under the terms and conditions of this Form, including the General Conditions
contained therein, as well as the Infocert Documentation.

Place and Date _____/_____/_____ Signature_________________________

The undersigned Holder also declares to specifically approve, pursuant to art. 1341 and 1342 of the Civil Code, the provisions of the following
"General Conditions":
art. 1 (Terms and conditions of the Service); art. 3 (Responsibility of the Applicant and the Holder); art. 6 (Suspension clause. Right of
withdrawal. Termination); art. 8 (Digital Signature Services Request Form); art. 10 (Obligations of the Holder and the Applicant);art. 12 (Duration of the
contract and validity of the certificate); art. 14 (Revocation suspension and restoration of the certificate); art. 16 (Termination of the relationship).

Place and Date _____/_____/_____ Signature_________________________

Consent to further use of personal data

InfoCert kindly asks you to agree or disagree to the processing of your data for further communication purposes which
may be carried on by other entities providing goods or services with which InfoCert SpA signed trade agreements, for
market research purposes, for commercial offers on InfoCert products and services and / or for sending marketing
information and other commercial communications.
The applicant, recognizing the processing of data by InfoCert,

□ Agrees □ does not Agree

Signature_________________________________

According to D. L.vo. no. 206/2005 (the "Consumer Code"), please be informed that, before the execution of the
contract, you will have the right to revoke this request by means of a special communication to be addressed to
InfoCert SpA, Piazza Luigi da Porto, 3, 35131 Padua, within ten days following the request..

To be completed by InfoCert:

I, the undersigned, SURNAME_______________________________ NAME__________________________

TAX CODE (e.g. Fiscal Code in Italy) _____________________________________________________,
represent to have complied, as provided by applicable laws and regulations and by the operating manuals issued
by the Certifier, with the recognition of the applicant’s identity as specified above and that the applicant’s personal
data are compliant with those contained in the original of the exhibited document.

Date _____/_____/_____/ the Registration Delegate (signature) ___________________________

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