AL TRIBUNALE ORDINARIO DI GORIZIA

Il/la sottoscritto/a _________________________________________________________________
nato/a a ______________________________________________ il _________________________
codice fiscale ____________________________________________________________________
residente in _____________________via (corso)________________________________________
cittadino________________________________tel. ______________________________________
e-mail___________________________________________________________________________
e la sottoscritta ___________________________________________________________________
nata a ______________________________________________ il __________________________
codice fiscale ____________________________________________________________________
residente in _____________________via (corso)________________________________________
cittadina__________________________________tel.____________________________________
e-mail___________________________________________________________________________

c h i e d e / c h i e d o n o

la rettifica dell’atto di matrimonio_____________________________________________________
in quanto sullo stesso  ______________________________________________________________
risulta __________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
anziché__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
come si deduce dai documenti allegati.

Gorizia, ______________                                                ___________________________
                                                                                                  Firma (marito)
	
                                                                                        ___________________________
                                                                                                  Firma (moglie)