Zone/Scrutiny Code

By Registered Post/Speed Post Only

1AL
To

GATE 2013
Chairman GATE Indian Institute of Science, Bangalore Bengaluru, 560012

From Sanjeev Kumar
TYPE-C-201 RTPS COLONY SHAKTINAGAR RAICHUR Karnataka, 584170

197 A 007 J

81051 67780

(Mobile No.)

Cut Here

Instructions to the Applicant (GATE 2013)
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 color photograph 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 your Principal’s or HOD’s sign and seal in the last portion of the application form. Submit the whole form to the Principal’s office without cutting it. 5. If you have opted for Challan payment, wait for 48 hours after your online submission to visit the bank’s branch. 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 and then accept the payment. The bank will retain one copy and give you back the remaining copies: one of which 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 check list 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.

Note: Application ID - 197 A 007 J. You should preserve this number for further correspondence.

.. 587102 Zonal GATE Office Contact Chairman GATE Indian Institute of Science.. 560012 Payment Details Online Rs.E.B) Male (Name of Parent) GEN Do not Attest Do not sign on photo Indian National Khirappa Kanni Communication Address TYPE-C-201 RTPS COLONY SHAKTINAGAR RAICHUR Karnataka..com 81051 67780 (Mobile No......./. 584170 India GATE Exam Details ME (GATE Paper code) Bengaluru. Applicant’s signature inside the box in black ink This space is intentionally left blank . if any suppression or distortion of facts is found after appearing in the exam.5 cm (Application ID) Sanjeev Kumar 197 A 007 J 01 Feb 1988 (D.) No Qualification Details B.. Bangalore Bengaluru. KA (Exam City 1) Gulbarga. Digital Fingerprint: 2c16da7528029b3a9f71da44e83d94db Date: . In the event of suppression or distortion of any fact in my application form. I have read the Information Brochure and I shall abide by the terms and conditions therein.. 1200. Graduated: Yes... Year of Graduation: 2010 Basaveshwar Engineering College. I understand that I will be denied the opportunity to appear in GATE 2013.../. KA (Exam City 2) Scribe Assistance Required: sanju288@gmail..00 Docs Uploaded Eligibility Certificate MFBK2819063709 29/09/2012 I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief.. Further. Mechanical Engg.5 cm x 3.. any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.O.Zone/Scrutiny Code 1AL 197 A 007 J (Full Name of Applicant) GATE 2013 Application Form Applicant's recent photograph 4...Bagalkot BagalkoT Karnataka.

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