YOUR DETAILS
Please tick / complete the appropriate boxes
1. My original certificate has not been received within
60 working days
(note 7)
n
2. My original certificate has been lost / stolen (note 8) –
payment required
n
3. I did not receive a certificate for the qualification noted
at section 4 and confirm that:
(note 9)
n
I changed my address or employer without advising
The London Institute of Banking & Finance whilst
studying – payment required
n
I notified The London Institute of Banking & Finance
prior to the date of issue of the certificate of my change of:
Address on (date)
nn
/
nn
/
nnnn
Employer on (date)
nn
/
nn
/
nnnn
I have contacted my previous employer to obtain the
certificate but they do not have it
n
4. My certificate is incorrect (note 10)
n
The correction required is:
–––––––––––––––––––––––––––––––––––––––––––––––––––––––
–––––––––––––––––––––––––––––––––––––––––––––––––––––––
I notified The London Institute of Banking & Finance of this
error on receipt of:
My registration confirmation letter dated
nn
/
nn
/
nnnn
My record of achievement letter dated
nn
/
nn
/
nnnn
The original certificate must be returned with your application
5. My certificate has been damaged
(note 11)
n
In transit
n
After receipt – payment required
n
Please describe the damage:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
The original certificate must be returned with your application
6. My name has changed and I enclose:
(note 12) –
payment required
n
Marriage certificate
n
Deed poll
n
The original certificate must be returned with your application
7. Other
(note 13) – payment required
n
Please explain why you are asking us to issue another certificate
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
SECTION 4 – REASON FOR REQUESTING A NEW
CERTIFICATE
(NOTE 6)
YOUR DETAILS
TOTAL PAYABLE £ ____________
Payment options
n
Please send me an invoice
n
I enclose a cheque for the total payable, made payable to
The London Institute of Banking & Finance
n
I will pay by bank transfer (ensuring all bank charges
are covered)
n
I authorise The London Institute of Banking & Finance to
debit my Visa / MasterCard / debit card for the total payable
Card number
nnnn nnnn nnnn nnnn
Expiry date
nn
/
nn
Valid from
nn
/
nn
Issue number
nnn
(if applicable) Security number*
nnn
Signed (note 15)______________________________ Date _________________
*
This is the last 3 digits found on the signature strip on the reverse of your card.
Bank transfer information (please provide your details with the
transfer so we can trace your payment):
Account Name: The London Institute of Banking & Finance
Account Number: 10514632
Sort Code: 20-18-00
International Bank Account Number (IBAN): GB83 BARC 2018
0010 5146 32
SWIFTBIC (Bank Identifier Code): BARCGB22
SECTION 5 – PAYMENT DETAILS
(NOTE 14)
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 have read the Higher Education Certification Policy and
understand it.
Signed
(note 16)______________________________ Date _________________
Please note that unsigned forms will be returned and will result in a delay in the
processing of your request
.
SECTION 7 – 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 6 – PERSONAL DATA
Your details
Date form received _______________________
Checked by______________________________ Date___________
Correct payment of £ ______________
Received and processed? Yes
n
No
n
Request checked against policy
n
Request rejected by _____________________ Date___________
Because _________________________________________________
Request approved by _____________________ Date___________
Transcript Issued on___________
Certificate number ___________________ Issued on___________
Transcript/certificate sent to student by_______________________
OFFICE USE ONLY