Zone/Scrutiny

By Registered Post/Speed Post Only

6NP
To

GATE 2014
A301P58 Chairperson GATE Indian Institute of Technology Kharagpur Kharagpur 721302

From Karumuri Kanaka Maha Lakshmi

34-8-1 gnanapuram post office street visakhapatnam VISAKHAPATNAM Andhra Pradesh 530004 73961 91928 (Mobile Number) Cut Here

A301P58

Instructions to the Applicant (GATE 2014)

1. This print out should contain the following pages. (a) Page 1 : This page contains Instructions and Address Slip (cut and paste the Address Slip on A4 size envelope). (b) Page 2 : Application form that you have filled online. 2. Bank challan in Triplicate is available as a separate pdf file to be downloaded. This is available only if you have opted for Offline Payment. 3. On the GATE 2014 Application Form, paste a 3.5cm x 4.5cm color photograph with plain background (this should be the same that you have uploaded during application filling). The photograph should be taken in a studio. (a) Write your Enrolment ID. and Name on the reverse side of the photo. (b) Use good quality glue to ensure that the photograph does not separate from the application. (c) Do not pin, staple, sign or attest the photograph. 4. Read the declaration and put your full signature in the box next to it. Please note that signature should not be in capital letters. 5. If you are in the final year or you have a backlog after appearing for the final year examination, you must get your Principals or HODs Signature and Seal in the Certificate from Principal that is provided at the last portion of the application form. Submit the whole form to the Principals office without cutting it. 6. 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. 7. The bank teller will verify the details printed on the challan with the data available in their system and then accept the payment. The bank will retain one copy and give you the remaining two copies: one of which is the GATE Copy that you have to send along with the printed application form and the other is the Candidate Copy for your reference. 8. Keep a photo copy of the completed application form for your reference. 9. Mailing Documents to GATE office. (a) Cut the Address Slip and paste it onto an A4 size 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. Mark the enclosures in 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 in the address slip. The application packet should REACH the respective zonal GATE office on or before Thursday, 10 October 2013.

Note: Enrolment ID - A301P58. You should preserve this number for further correspondence.

Zone/Scrutiny

GATE 2014

Applicant's recent photograph

6NP
A301P58
(Enrolment ID) (Full Name of the Applicant)

A301P58

A301P58

3.5 cm x 4.5 cm

Karumuri Kanaka Maha Lakshmi

A301P58

21 Aug 1992
(D.O.B)

Female
(Gender)

GEN
(Category)

No
(PD Status)

Do not Attest Do not sign on photo Do not staple photo

Indian National

9985855732
(Parent's Mobile Number)

K Sathi Babu
(Name of the Parent)

Communication Address
34-8-1 gnanapuram post office street visakhapatnam VISAKHAPATNAM Andhra Pradesh 530004

GATE Exam Details

GATE Paper Code

ME
Visakhapatnam, AP
(Exam City 1)

73961 91928 (Mobile No.) kanakamahalakshmi743@gmail.com

Srikakulam-Vizianagaram, AP
(Exam City 2)

Qualification Details
B.Tech Mechanical Engg. Graduated: No; Year of Graduation: 2014 SITAM aff.JNTU KAKINADA VISAKHAPATNAM Andhra Pradesh 530041

Vijayawada, AP
(Exam City 3)

Zonal GATE Office Contact

Chairperson GATE Indian Institute of Technology Kharagpur Kharagpur 721302

Payment Details

Online
03/10/2013

Rs. 750.00

Payment Ref. No.: MSBI3123889599

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 2014 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 2014. 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 2014 score/marks is liable to be cancelled.

Digital Fingerprint:

bbc56c2d06407e59713ff5f8837543e8

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

Applicants signature inside the box in black ink

Certificate from Principal

(For use as the eligibility certificate only for final year or backlog applicants)

This is to certify that Karumuri Kanaka Maha Lakshmi is a student enrolled in SITAM aff.JNTU KAKINADA, VISAKHAPATNAM. She is a student of the final year of B.Tech. She appeared in the final semester/year exam of the above degree, but has a backlog to be cleared from an earlier semester/year, and therefore cannot produce a course completion certificate.

Date:

Signature of Principal/ HOD

Seal