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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.

136/99C

TRICHY

THIRUVANAIKOVIL

Instructions to the Applicant (GATE 2013)

Zone/Scrutiny Code

7ALBy Registered Post/Speed Post Only

(Mobile No.)

Indian Institute of Technology Madras

GATE 2013

Tamil Nadu, 620005

To

R.Navaneetha Krishnan

Chairman GATE

85084 75408

206 H 499 Z

Chennai, 600036

Cut Here

NORTH STREET

From

Note: Application ID - 206 H 499 Z. You should preserve this number for further correspondence.

7/28/2019 206 h 499 z Application

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(Application ID)206 H 499 Z

GATE 2013Zone/Scrutiny Code

Payment Details

Rs. 1200.00

7AL

D.O.B)

Scribe Assistance Required:

Qualification Details

(Exam City 1)

R.Navaneetha KrishnanFull Name of Applicant)

9 Feb 1987 Male

ndian National

GEN

No

B.E.

Tiruchirapalli, TN

Thanjavur, TN

EE

S.Rangarajan(Name of Parent)

Tamil Nadu, 620005

Tamil Nadu, 620009

suresh8719@gmail.com

NORTH STREET

J.J.COLLEGE OF ENGINEERING AND TECHNOLOGY

(GATE Paper code)

Communication Address

Graduated: Yes, Year of Graduation: 2010

Electrical Engg./Electrical and Electronics Engg./Power

85084 75408

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:

TRICHY

THIRUVANAIKOVIL

OnlineMSBI2817013742

136/99C

4.5 cm x 3.5 cm

Zonal GATE Office Contact

Chairman GATEIndian Institute of Technology Madras

Chennai, 600036

fd989d8306b72b2fe1e41c3de56b352a

Applicant's recent photograph

206 H 499 Z

GATE Exam Details

(Mobile No.)

(Exam City 2)

Applicants signature inside the box in black ink

26/09/2012

Date: ....../....../............

India

This space is intentionally left blank

TRICHY

Application Form

Do not AttestDo not sign on photo

Docs Uploaded Eligibility Certificate