Speaking Candidate speaking authentication

sheet (CS4)
This form must accompany candidate recordings sent to the Pearson-
appointed examiner.

Pearson Edexcel Level 3 Advanced GCE

Centre name: Centre Number: Paper code:

Candidate name Candidate Declaration and permissions Date

number signature*

Teacher name **Declaration and permissions Date

signature

* Candidate declaration
I certify that the work submitted for this assessment is my own. I have clearly referenced any sources used in the
work.
I understand that false declaration is a form of malpractice. I agree to my work being used to support
Professional Development, Online Support and Training of both teacher/examiners.
** Teacher declaration
I declare that the above examinations have been carried out in line with Pearson and JCQ documentation
for the conduct of the examinations and agree to this work being used to support teachers and examiners.

Please photocopy and continue on a separate sheet if necessary.

*** Head of Centre / Head Teacher declaration (‘London Centre Orals’ ONLY): I certify that the target
language is not taught at the centre and cannot be examined.

Print name (Head of Centre / Head Teacher) Signature Date