M071NOV2022 – Evidence Request Form [21_11_2022] – SZ406

Please provide us with the evidence requested in the table below by completing the attached
statement forms.

Evidence requested

Head of Centre statement Please tick to confirm that

evidence is being provided


Teacher statement Please tick to confirm that
evidence is being provided
Please show the Teacher the following evidence before asking them to
complete their statement: 
Please tick to confirm that the
 Head of Centre statement evidence listed has been shown to
the teacher.


Please tick to confirm that
Training records for the teacher evidence is being provided


Please tick to confirm that
A copy of your centre’s procedures for: evidence is being provided
 Receiving and downloading confidential exam material sent via
Digital File Download 
If there is any further evidence that we have not requested that is relevant to this case please provide details
of the additional evidence you are submitting here:

Section 5.6.5 of the Cambridge Handbook 2022 states that the Head of Centre must make any individual
accused of malpractice aware, preferably in writing, of the suspected malpractice and possible consequences at
the earliest opportunity. Any individual accused of malpractice must also:
• be made aware of the nature of the suspected malpractice
• be given the opportunity to submit a written statement
• be informed of our appeals procedure.

Please tick this box to confirm that any individuals accused of malpractice have been made aware of
the information in section 5.6.5 of the Cambridge Handbook 2022 before completing their statement 
Returning Evidence
Please return the requested evidence and this form by replying to our email. Please include your centre number,
case number and ‘Suspected Malpractice Evidence’ in the email subject line. If you are an Associate Centre
and work with us through a Cambridge Associate please submit this form and the requested evidence directly to
them.

All attachments should be named with the following naming convention:

[Case number] – [Evidence Name] – [Centre Number]
For example, M000JUN2020 – Head of Centre Statement – AB123

The Head of Centre must sign to confirm that they have completed this form and that they have checked to make sure it is
accurate.

Head of Centre name Date Click here to enter a

(DD/MM/YY) date.