Explanation for High Similarity Index Form

Student Name: [Full Name]

Student Number: [Student No.]
Course of Study: [Select Course]
Intake/Cohort: [State Intake/Cohort]
Campus: [State Campus]
Module: [State Module Title]
Module Lecturer: Please enter name of Module Lecturer

Please select accordingly.

Assessment 1 Assessment 2 Assessment 3 Assessment 4

Similarity Index (SI): [State the SI %] %

(Please attach Similarity Report)
Explanation: [Provide explanation for the High Similarity Index (i.e., SI of 20% or more]

Student’s Signature: Date: Click or tap to enter a date.

NIEC 2023_v1.0
 For Official Use
Module Lecturer’s Recommendation
(Select the recommended action(s) and state the reason(s) below.

No further action required (i.e., deemed to Found to have committed Plagiarism - Refer to
have NOT plagiarised) CDC / NDC1 for further inquiry/action(s)
Reasons: [Indicate Findings & Reasons for Recommendation]

Signature: Date:
Click or tap to enter a date.

Course Lead / Programme Head‘s Endorsement

Recommendation endorsed by: Name: Date:
Name
Signature: Click or tap to enter a date.
(Indicate accordingly)
Course Lead
Programme Head

For Cases Referred to CDC/NDC

Outcome by: Please indicate the applicable outcome and state the punitive action(s)
(Indicate accordingly) in the remarks below.
CDC No further action required (i.e., deemed to have NOT plagiarised)
NDC Found to have committed Plagiarism
Remarks: [Rationale & Recommended Punitive Action]

*To be completed and send to SAS for record purposes [aa@niec.edu.sg]

1
CDC refers to the Campus Disciplinary Committee; NDC refers to the NIEC Disciplinary Committee
NIEC 2023_v1.0