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 Principals or HODs sign and seal in the last portion of the application form. Submit the whole form to 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 banks 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.

G2

ONGOLESivaji Nagar 1st line MM Donkka

Instructions to the Applicant (GATE 2013)

Zone/Scrutiny Code

1ALBy Registered Post/Speed Post Only

(Mobile No.)

Indian Institute of Science, Bangalore

GATE 2013

Andhra Pradesh, 523002

To

Koduri Nireesha

Chairman GATE

89777 28262

156 J 747 W

Bengaluru, 560012

Cut Here

SRI SAI ENCLAVE

From

Note: Application ID - 156 J 747 W. You should preserve this number for further correspondence.

(Application ID)156 J 747 W

GATE 2013Zone/Scrutiny Code

1AL

(D.O.B)

Scribe Assistance Required:

Qualification Details

(Exam City 1)

Koduri Nireesha(Full Name of Applicant)

05 Jul 1991 Female

Indian National

GEN

No

B.Tech

Hyderabad, AP

Secunderabad, AP

EE

Koduri Venkata Seshaiah(Name of Parent)

Andhra Pradesh, 523002

Andhra Pradesh, 523272

nireesha.koduri@gmail.com

SRI SAI ENCLAVE

PACE INSTITUTE OF TECHNOLOGY AND SCIENCES

(GATE Paper code)Communication Address

Graduated: Yes, Year of Graduation: 2012Electrical Engg./Electrical and Electronics Engg./Power

89777 28262

I hereby declare that all the particulars stated in this application form are true to the best of my knowledgeand belief. I have read the Information Brochure and I shall abide by the terms and conditions therein. In theevent of suppression or distortion of any fact in my application form, I understand that I will be denied theopportunity to appear in GATE 2013. Further, if any suppression or distortion of facts is found after appearingin the exam, any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.

Digital Fingerprint:

ONGOLESivaji Nagar 1st line MM Donkka

G2

4.5 cm x 3.5 cm

Zonal GATE Office ContactChairman GATEIndian Institute of Science, BangaloreBengaluru, 560012

d63c4bff5821c0d15664705c033b2608

Applicant's recent photograph

156 J 747 W

GATE Exam Details

(Mobile No.)

(Exam City 2)

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

India

This space is intentionally left blank

ONGOLE

Application Form

Do not AttestDo not sign on photo

Docs Uploaded Eligibility Certificate