Declarație pe proprie răspundere, tradusă in limba engleză

Romanian Government

AFFIDAVIT

The undersigned: …………………………………………………………………………………………..

domiciled in: …………………………………………………………………………………………………

with the residence in fact in: …………………………………………………………………………………

born on: ……… ……… …………….. in the city of ……………………………………………………….

I take it upon myself to declare, knowing the provisions of article 326 of the Criminal Code regarding false statements, that I’m travelling outside my home, between 11.00 PM and 05.00 AM, for the following reason/reasons:

  • For professional purposes. I mention that I carry out my professional activity at the institution / company / organization ……………………………………………………………………………..

with the head office in ………………………………………………………………………………

and with work point(s) at the following addresses: …………………………………………………

…………………………………………………………………………………………………………

…………………………………………………………………………………………………………

  • Medical care that cannot be postponed or performed remotely
  • Purchase of medicines
  • Child care / accompaniment and/or assistance for the elderly, sick or disabled
  • Death of a family member

Date ………………………………….                           Signature ………………………………………

*The affidavit may be written by hand, provided that all the elements presented above are included.

**The affidavit may be stored and presented for control on mobile electronic devices, provided that the document presented contains the handwritten signature of the person using the Affidavit and the date for which the declaration is valid.