Result Enquiry Application Form (Financial Capability)
This form must be returned to The London Institute of Banking & Finance within 10 working days of the release of the provisional
examination results. Please see the Key Dates and Deadlines document for set-date examinations deadlines. Forms received after the
specified deadline will not be processed. The fee for this service is £42
; this form will not be accepted by The London Institute of Banking &
Finance if it does not include the appropriate fee.
Please return this form to fcexams@libf.ac.uk
The London Institute of Banking & Finance is a registered charity, incorporated by Royal Charter.
YOUR DETAILS
Centre name _______________________________________________________________________ Centre postcode __________________________________________
Examinations officer name _________________________________________________________ Contact number __________________________________________
SECTION 1 CENTRE DETAILS
YOUR DETAILS
If you have more than one student requesting a result enquiry for the same reason, then please complete one form and list all
students below.
Student name ___________________________________________________________________
___ LIBF number _____________________________________________
Qualification ________________________________________________________________________ Unit ______________________________________________________
Exam session number ______________________________________________________________ Exam date _______________________________________________
Additional students (if required) ________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
SECTION 2 STUDENT DETAILS
YOUR DETAILS
Please describe the circumstances that you believe have led to an unfair and/or inaccurate result of the examination:
Please continue on a separate sheet if necessary
SECTION 3 BASIS FOR REQUESTING A RESULT ENQUIRY
YOUR DETAILS
n
I declare that the information contained in this form is true and accurate, consent to the processing and use of personal data as
outlined in the Privacy Notice and accept our terms and conditions.
n
I understand that the outcome of this result enquiry is final, and may lead to an increase or decrease in total marks awarded.
Examinations officer signature ______________________________________________________________________ Date ___________________________________
Please note that all unsigned forms will be returned and will result in a delay in the processing of your enquiry.
SECTION 6 DECLARATION
YOUR DETAILS
We will use and protect your personal data in accordance with current data protection legislation to evaluate your claim. Further details,
including your rights, the disclosure of data to third parties, storage, retention and how to amend your personal data, can be found within
our Privacy Notice (www.libf.ac.uk/privacy)
SECTION 5 YOUR PERSONAL DATA
GT09/20
YOUR DETAILS
Please tick one payment option:
n
I enclose a cheque for the total amount payable
n
I would like the centre to be invoiced for the total amount payable (requires an Examination Officer signature)
_____________________________________
n
I authorise The London Institute of Banking & Finance to debit my Visa / MasterCard / Switch Card for the total amount payable
42.00 per Result Enquiry)
Card number
______________________________________________________
Name on card
_____________________________________________________
Expiry date
_________ /_________ Valid from _________ /_________ Issue number _______(if applicable) Security number
***
_________
Cardholder signature ______________________________________________ Date _____________________________________________________
Address and postcode of cardholder:
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
***
This is the last 3 digits found on the signature strip on the reverse of your card.
SECTION 4 - PAYMENT DETAILS
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