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.

C/O- BABA MEDICAL STORE

SHAHJAHANPURAJIJGANJ

Instructions to the Applicant (GATE 2013)

Zone/Scrutiny Code

3ALBy Registered Post/Speed Post Only

(Mobile No.)

Indian Institute of Technology Delhi

GATE 2013

Uttar Pradesh, 242001

To

Alok Kumar Gupta

Chairman GATE

93047 72036

203 H 358 G

Hauz Khas, New Delhi, 110016

Cut Here

OPP- NEW DISST HOSPITAL

From

Note: Application ID - 203 H 358 G. You should preserve this number for further correspondence.

(Application ID)203 H 358 G

GATE 2013Zone/Scrutiny Code

Payment DetailsRs. 1200.00

3AL

(D.O.B)

Scribe Assistance Required:

Qualification Details

(Exam City 1)

Alok Kumar Gupta(Full Name of Applicant)

01 Mar 1983 Male

Indian National

OBC-NC

No

B.Tech

Delhi South, DL

Delhi East, DL

ME

Om Prakash Gupta(Name of Parent)

Uttar Pradesh, 242001

Bihar, 800005

a_k_g123@yahoo.com

OPP- NEW DISST HOSPITAL

N.I.T PATNA

(GATE Paper code)Communication Address

Graduated: Yes, Year of Graduation: 2010Mechanical Engg.

93047 72036

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:

SHAHJAHANPURAJIJGANJ

OnlineMSBP2816942201

C/O- BABA MEDICAL STORE

4.5 cm x 3.5 cm

Zonal GATE Office ContactChairman GATEIndian Institute of Technology DelhiHauz Khas, New Delhi, 110016

2903b0757f321f6bf52aa29d1bc9462a

Applicant's recent photograph

203 H 358 G

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

PATNA

Application Form

Do not AttestDo not sign on photo

Docs Uploaded Eligibility Certificate