7/31/2019 108 e 283 k Application

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1. This print out should contain the following pages.

(a) This page: Address Slip and Instructions.(b) Application form, filled with the information you provided online.(c) Bank Challan in Triplicate (available as a separate file for download from the

GATE Online Application Interface), if you have chosen Offline Challan Payment (Not applicable for female candidates).

2. On the GATE copy of the Application Form, paste a 4.5cm x 3.5cm printed copy of the SAME colorphotograph you uploaded online.(a) Use good quality glue to ensure that the photograph does not separate from the application.(b) Do not pin, stapple, sign, or attest the photograph.

3. Read the declaration and put your signature in the box next to it.

4. If you are in the final year or you have a backlog after appearing for the final year exam, you must get yourPrincipals or HODs sign and seal in the last portion of the application form. Submit the whole formto the Principals office without cutting it.

5. If you have opted for Challan payment, wait for 48 hours after your online submission to visit the banksbranch. You can visit any branch of the bank printed on your challan.

6. The bank teller will verify the details printed on the challan with the data available on their computer andthen accept the payment. The bank will retain one copy and give you back the remaining copies: one ofwhich you have to send along with the printed application form and the other is for your reference.

7. Mailing Documents to GATE office.(a) Cut the Address Slip and paste it onto an A4 sized envelope (Do not fill address by hand or tamper the

address slip).(b) Collect the supporting documents shown under Enclosure Checklist in the application form (if you

have uploaded the soft copy of the documents online, you need not send a hard copy). Mark the checklist boxes.

(c) Do NOT FOLD the application form and Do NOT STAPLE or pin the documents to the form.(d) Send the packet by Speed Post (preferably) or by Registered Post to the address mentioned. The

application packet should REACH the respective GATE office on or before Monday, 8 October 2012.

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BANGALORE

KENGERI SATELLITE TOWN

Instructions to the Applicant (GATE 2013)

Zone/Scrutiny Code

1MXBy Registered Post/Speed Post Only

(Mobile No.)

Indian Institute of Science, Bangalore

GATE 2013

Karnataka, 560060

To

Dinesh Kumar K

Chairman GATE

99004 45523

108 E 283 K

Bengaluru, 560012

Cut Here

1ST MAIN, 11TH CROSS, GAYATHRI MANDIRA ROAD

From

Note: Application ID - 108 E 283 K. You should preserve this number for further correspondence.

7/31/2019 108 e 283 k Application

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(Application ID)08 E 283 K

GATE 2013Zone/Scrutiny Code

Payment Details

Rs. 600.00

1MX

D.O.B)

Scribe Assistance Required:

Qualification Details

(Exam City 1)

Dinesh Kumar KFull Name of Applicant)

1 Aug 1990 Male

ndian National

SC

No

B.E.

Bengaluru, KA

Mysore, KA

EC

Raju K M(Name of Parent)

Karnataka, 560060

Karnataka, 560060

katamdineshkumar@gmail.com

1ST MAIN, 11TH CROSS, GAYATHRI MANDIRA ROAD

J.S.S.A.T.E

(GATE Paper code)

Communication Address

Graduated: Yes, Year of Graduation: 2012

Electronics/Comm./Telecomm Engg.

99004 45523

hereby declare that all the particulars stated in this application form are true to the best of my knowledgend belief. I have read the Information Brochure and I shall abide by the terms and conditions therein. In thevent of suppression or distortion of any fact in my application form, I understand that I will be denied the

pportunity to appear in GATE 2013. Further, if any suppression or distortion of facts is found after appearingn the exam, any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.

Digital Fingerprint:

BANGALORE

KENGERI SATELLITE TOWN

ChallanCanara Bank

8

4.5 cm x 3.5 cm

Zonal GATE Office Contact

Chairman GATEIndian Institute of Science, Bangalore

Bengaluru, 560012

05ea9efe0ccde34461ad1a930c39cebc

Applicant's recent photograph

108 E 283 K

GATE Exam Details

(Mobile No.)

(Exam City 2)

Enclosure Checklist

Applicants signature inside the box in black inkDate: ....../....../............

Stamped Bank Challan: GATE copy

India

This space is intentionally left blank

BANGALORE

Application Form

Do not AttestDo not sign on photo

Docs Uploaded Eligibility Certificate, SC/ST Certificate