CILEx Legal Services Qualifications

Level 4 Competence Qualification

Claim Form

This form should be used for all learners studying the Level 4 Diploma in Providing Legal Services.

Centres should complete this form electronically (in Word) and send it via email to: by the centre claim deadline which has been agreed with your EQA and CILEx.Please do not submit this form as a PDF.

Please note the following:

  1. This form identifies those learners for whom you are seeking unit certification at the EQA visit. Learners who are not listed on this form or who are not listed on this form for each unit claim being made will not be certificated at this time.
  1. Centre Assessor and Internal Quality Assurernames and initials must be added below as appropriate in respect of each unit claimed by learners. No claim form must be submitted without these boxes being completed for those units claimed, and completion of these boxes means that the identified Centre Assessor/Internal Quality Assurerhas fully satisfied the required centre assessment/internal quality assuranceresponsibilities in respect of the unit indicated and for the learners listed for that specific unit.
  1. The initials of the Centre Assessor allocated to each learner must be entered in the column next to the Learner’s name.
  1. Centres making claims for more than 4 units should contact . CILEx will amend the form for the number of units required.
  1. If a centre is claiming unit achievement for a particular unit for more than 10 learners, copy and insert additional rows into the table or contact r assistance.
  1. In sending this form electronically to CILEx to make a claim for the learners listed for the units indicated, the accredited centre agrees that they have completed the form fully, that they have followed the above instructions and that they will, upon production of the CILEx invoice for the amount identified in Section 3, pay CILEx fully the amount indicated and in agreement with CILEx’s payment terms.

Section 1 - Centre details

Centre Name: / Another Centre / Centre Contact Name: / Alison Smith
Centre Contact Email: / / Centre Contact: Telephone number: / 01234 567890
EQA Name: / Tim Jones / Date of EQA Visit: / 27th January 2016

Section 2 – Details of Claims

For each unit the learners for whom a claim is being made should be listed (name, centre assessor initials, CILEx membership number), along with the details of the centre assessor/s and centre IQA/s who have signed off achievement of the unit.

Unit Number and Name: / Unit 1 Communicate effectively with people /
Learner name Insert names of learner who have achieved the above unit / Centre Assessor Initials / CILEx Membership Number / CILEx Use Only
Candidate Number / CILEx Use Only
EQA sign off
A Brown / BT / 1234565 / Choose an item. /
B Williams / BT / 2385476 / Choose an item. /
C Singh / BT / 8584758 / Choose an item. /
D Black / BT / 5847965 / Choose an item. /
E Peters / BT / 9685847 / Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Centre Assessor Name/s and initials / Bob Taylor (BT)
Centre IQA Name/s: / Sarah Davies
Date: / 5th January 2016
Unit Number and Name: / Unit 2 Comply with legal, organisational and regulatory requirements in the provision of legal services /
Learner name Insert names of learner who have achieved the above unit / Centre Assessor Initials / CILEx Membership Number / CILEx Use Only
Candidate Number / CILEx Use Only
EQA sign off
A Brown / BT / 1234565 / Choose an item. /
B Williams / BT / 2385476 / Choose an item. /
C Singh / BT / 8584758 / Choose an item. /
D Black / BT / 5847965 / Choose an item. /
E Peters / BT / 9685847 / Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Centre Assessor Name/s and initials / Bob Taylor (BT)
Centre IQA Name/s: / Sarah Davies
Date: / 5th January 2016
Unit Number and Name: / Unit 3 Draft legal documents /
Learner name Insert names of learner who have achieved the above unit / Centre Assessor Initials / CILEx Membership Number / CILEx Use Only
Candidate Number / CILEx Use Only
EQA sign off
A Brown / BT / 1234565 / Choose an item. /
B Williams / BT / 2385476 / Choose an item. /
C Singh / BT / 8584758 / Choose an item. /
D Black / BT / 5847965 / Choose an item. /
E Peters / BT / 9685847 / Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Centre Assessor Name/s and initials / Bob Taylor (BT)
Centre IQA Name/s: / Sarah Davies
Date: / 5th January 2016
Unit Number and Name: / Unit 4 Equality and diversity /
Learner name Insert names of learner who have achieved the above unit / Centre Assessor Initials / CILEx Membership Number / CILEx Use Only
Candidate Number / CILEx Use Only
EQA sign off
A Brown / BT / 1234565 / Choose an item. /
B Williams / BT / 2385476 / Choose an item. /
C Singh / BT / 8584758 / Choose an item. /
D Black / BT / 5847965 / Choose an item. /
E Peters / BT / 9685847 / Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Choose an item. /
Centre Assessor Name/s and initials / Bob Taylor (BT)
Centre IQA Name/s: / Sarah Davies
Date: / 5th January 2016

3. Invoicing details

CILEx will issue an invoice for the total number of claims made on this claim form after the CILEx External Quality Assurer’svisit has taken place.

Payment terms are strictly 28 days from the date of the invoice. Payment can be made via BACS, Credit Card or cheque (made payable to CILEx). Non-payment of invoices may result in further services being suspended. Any outstanding debts will be notified by monthly statements until the balance is cleared.

CILEx Office Use Only
Total number of unit claims:
Insert total number of units claims claimed on this form / 20
Fee per unit claimed: / £8
Total cost of unit claims:
Insert total cost of unit claims / £160

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