Modulo 3 / fronte
Scheda informativa
foto
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DATA Inizio mandato
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COGNOME (per le coniugate il cognome da nubile)
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NOME
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Parrocchia / Comunità religiosa / Cappellania
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Nato a
il
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Residente in Via ____________
n.
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CAP - Località
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TelefonoCellulare
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E-mail