Zone/Scrutiny GATE 2019

1OB C255Z55
C255Z55 (Enrollment ID)

SAMEER
(Full Name of the Applicant)

04 Aug 1996 Male OBC

(D.O.B) (Gender) (Category)

Indian +91-8050669091 NOOR MEHDI

National (Mobile Number of Parent/Guardian) (Name of Parent/Guardian)

Communication Address GATE Exam Details

#14/1, 3rd cross, 5th main, GATE Paper Code
Near Radhkrishna Theatre,
RT Nagar , Bangalore
Bangalore
Karnataka 560032
ME
(Mechanical Engineering)
+91-8050669091 (Mobile No.)
Bengaluru South, KA
mdsameer786india@gmail.com (Exam City 1)

Qualification Details Ballari(Bellary), KA

(Exam City 2)
B.E.
Mechanical Engg. Mangaluru, KA
(Exam City 3)
Graduated: No; Year of Graduation: 2019
BANGALORE.INSTITUTE.OF.TECHNOLOGY Zonal GATE Office Contact
Bangalore Chairperson, GATE
Karnataka 560004 Indian Institute of Science Bangalore
Bengaluru 560012
Payment Details
Online Rs. 1500.00
Payment Ref. No.: NHMP6675416744 12/09/2018

I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and
belief. I have read the Information Brochure and I shall abide by the terms and conditions therein. The
responsibility of following the GATE 2019 website and meeting various deadlines lies with me. In the event of
suppression or distortion of any fact in my application form, I understand that I will be denied the opportunity
to appear in GATE 2019. Further, if any suppression or distortion of facts is found after appearing in the
exam, any admission/degree/benefit acquired on the basis of GATE 2019 score/marks is liable to be
cancelled.

Digital
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