INDIAN TECHNOLOGY CONGRESS 2016

Excellence in Engineering Practice: Networking and Collaboration

25 - 26 August 2016
NIMHANS Convention Centre, Bangalore

Abstract / Full Paper Declaration Form

This Declaration Form must be signed by the Author/all the authors (in case of joint authorship). In absence of
the duly filled-in Declaration Form paper will not be taken up for Proceedings.
Name of the Principal Author*(in BLOCK LETTERS)

Office Address*:

E-mail*:

Mobile*:

Name of the Co-Author-1 (in BLOCK LETTERS)

Office Address*:

E-mail*:

Mobile*:

PAPER ENTITLED ________________________________________________________________________________

________________________________________________________________________________________________
1. I/We certify that my/our above mentioned paper, now submitted to Indian Technology Congress 2016 (ITC 2016) for
publication in its Conference Proceedings, has neither been submitted for publication nor so far published in any
Conference/Journal or Magazine. I/We further undertake that the paper now submitted is not copied or plagiarized
version of some other published work.
1. I/We declare that I/we shall not submit the paper for publication in any other Conference/Journal or Magazine till the
decision of the ITC 2016 is made known to me/us.
2. If the paper is to be reprinted in any other Journal or Magazine subsequently, the permission of the ITC 2016 will be
duly taken well in advance.
3. I/We understand that submission of false or incorrect information/undertaking would invite appropriate penal
actions of the Conference. Legal action will be taken also as per IPC.
Signature:

Date: ____________________

Main Author Co-Author (1) ..

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Any change in the mailing address after submission of this Declaration Form, should promptly be intimated to the ITC
2016.
---------------------------------------------------------------------------------------------------------------------------------------------------------------Please mail this form to:
Organising Secretary
Indian Technology Congress
#5, Sri Vinayaka Towers, 7th Cross, KR Colony, Domlur Layout, Bangalore 560 071.
Ph : 080 6559 2501 Fax : 080-4115 2496 E-mail: participate@techcongress.net Web: techcongress.net