COMPANY LETTERHEAD

ENAC – Malpensa

Servizio Sicurezza SEA SpA

Ufficio Tesserini Aeroporto Malpensa

Object: Request of permanent personal access badge

Having taken note of all relevant Orders and Circulars in force, pursuant to the Presidential Decree 28 December 2000, no. 445, as amended, aware of the criminal consequences which could arise in the event of false declarations, we request the issue of a permanent access badge for the following employee:

1 / NAME and SURNAME /

NATIONALITY

/

□ M □ F

2 / PERMANENT EMPLOYMENT CONTRACT /

From

3 / FIXED-TERM EMPLOYMENT CONTRACT / From To
4 / INTERIM EMPLOYMENT CONTRACT /
YES
/
JOB PLACEMENT AGENCY
5 / JOB FUNCTION
6 / COMPANY NAME
In case of Subcontracts, supply or maintenance contracts, specify contract number / □ CONTRACTOR From To
CONTRACT NO.
□ SUB-CONTRACTOR From To
CONTRACT NO.
□ SUPPLIER or CLIENT From To
CONTRACT NO.
□ MAINTENANCE SERVICE SUPPLIER From To
CONTRACT NO.
7 /
EMPLOYEE REGISTER NUMBER
/ No.
8 / INPS POSITION / No.
9 / INAIL POSITION / No.
10 / In case of foreign workers NOT employed in Italy
Insurance company name
11 / In case of foreign workers NOT employed in Italy. Insurance policy no. / N.
12 /
BADGE COLOUR
/ RED / All Areas
GREEN / External Airside and internal access
BLU / Internal airside
YELLOW / Non security restricted areas
ORANGE / Diplomatic
13 / ACCESS TO AREAS / 1 / All areas / 5 / Aircraft
2 / Airside critical areas inside the Terminal / 6 / Apron area
3 / Baggage Sorting Area / 7 / Maneuvering area
4 / Cargo area
14 /
BRIEF JOB DESCRIPTION
15 /
USE OF PROHIBITED ARTICLES
Ex art. 1.3.1. EU Regulation 185/2010
/ CATEGORY / 1 / 2 / 3 / 4 / 5 / 6
16 /
E-Mail address and telephone n°
Belonging company
APPLICANT COMPANY
(Company stamp and signature) / BELONGING COMPANY
(Company stamp and signature) / BADGE HOLDER SIGNATURE / FIRMA TITOLARE BADGE

DATE ______

The company furthermore declares under its own responsibility that the applicant or the company are in possession of the following documents:

For Italian citizens:

◊ Identity card or Passport (driving licence is also accepted)

◊ Certificate of attendance to the Security Course

For Foreign citizens:

◊ Passport and permit to stay (if about to expire or expired, documents proving request for renewal must be presented)

◊ The Company is ensuring the necessary checks are performed in relation to the permit to stay renewal, during the entire period of personal access badge validity

◊ Certificate of attendance to the Security Course

For Employees of Security Services Companies ex DM. 85/99

◊ Valid Prefectural Decree

◊ Valid ENAC Certificate

◊ Administrative employees of Security Services Companies ex DM85/99, will have to present the original certificate of attendance to the security course.

◊ COPY of the Chamber of Commerce Company survey in case of first badge request.

◊ Certificate of eligibility issued by ENAC for ground handling companies acting on their own account regulated by Ministerial Decree 18/99.

◊ ENAC Authorization for the subcontracting companies of ground handling services regulated by Ministerial Decree 18/99.

The request form must completely filled in. on the company headed paper and in electronic format. Il must be clearly legible and completed with stamp and signature of both the applicant company and the belonging company.

The applicant company is responsible in case of false declarations and undertakes to carry out the appropriate surveillance to its employees activities concerning correct badge use and restricted areas access.

The applicant company also undertakes to timely return the badge when the access to airport areas is no longer needed.

INVOICING DATA (Registered Company name, registered office address, VAT Reg. No.) Page 1 of 2