Zone/Scrutiny Code GATE 2021

7OB B437N51
B437N51 (Enrollment ID)

CHANDINI
(Full Name of the Applicant)

29 Aug 1997 Female OBC-NCL

(D.O.B) (Gender) (Category)
Indian +91-8143247615 MOHAMMAD IBRAHIM
National (Parent/Guardian's Mobile Number) (Parent/Guardian's Name)

Communication Address GATE Exam Details

H NO 20-5-83/3 GATE Paper Code
GANDHI NAGAR GODAVARIKHANI
MANDAL RAMAGUNDAM DIST PEDDAPALLI
Godavarikhani
Telangana 505209
EC
(Electronics and
+91-6281918002 (Mobile No.) Communication
Engineering)
Qualification Details Exam City 1: Karimnagar (TS)
Exam City 2: Warangal (TS)
B.Tech
Electronics & Communication Exam City 3: Khammam (TS)
Graduated: Yes; Year of Graduation: 2018 Exam City 4: Hyderabad (TS)
UNIVERSITY COLLEGE OF ENGINEERING
KOTHAGUDEM Zonal GATE Office Contact
Telangana 507101 Chairperson, GATE
Indian Institute of Technology Madras
Payment Details Chennai 600036

Payment Mode Transaction Ref. No Transaction Date Amount Payment For

Online CPAAIFUWJ6 9/30/20 1:36 PM INR 750.00 Registration

I confirm that I fulfil the eligibility criteria to appear for the Graduate Aptitude Test in Engineering (GATE 2021)
examination and I, myself have filled up the entire form in the GOAPS portal. I have fully understood each and
every point in the form and filled up the details accordingly. I agree to strictly comply with the code of conduct
for GATE 2021 examination as detailed in Appendix B of the Information Brochure. I confirm that the
information provided by me in this form is correct in all respect. I also confirm that I am NOT filling more than
ONE form for myself.

If any of the information provided by me is found to be incorrect at any time later, my candidature for GATE
2021 will be cancelled. This cancellation of my candidature can happen either before, during or after the
examination, including the time after generation of my GATE 2021 score card, if any.

I also understand that GATE is NOT an admission ensuring examination, and qualifying in GATE examination
does NOT guarantee admission / scholarship / job. GATE 2021 committee is NOT liable for any legal
obligations related to admission / job.

I shall be liable for legal action for providing any type of false information. GATE 2021 committee's decision will
be final and legally binding on me.

e-Signature: CHANDINI
Digital Fingerprint: 4db9dbf867130c9e56253b093965b3a1