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.
#1560
Faridabad
Instructions to the Applicant (GATE 2013)
Zone/Scrutiny Code
3FF
By Registered Post/Speed Post Only
(Mobile No.)
Indian Institute of Technology Delhi
GATE 2013
Haryana, 121001
To
Dimpy Gambhir
Chairman GATE
89012 42820
217 G 108 Y
Hauz Khas, New Delhi, 110016
Cut Here
Sector-9
From
Note: Application ID - 217 G 108 Y. You should preserve this number for further correspondence.
(Application ID) 217 G 108 Y
GATE 2013
Zone/Scrutiny Code
3FF
(D.O.B)
Scribe Assistance Required:
Qualification Details
(Exam City 1)
Dimpy Gambhir
(Full Name of Applicant)
26 Dec 1989 Female
Indian National
GEN
No
B.Tech
Faridabad, HR
Delhi North, DL
CS
Mohan Gambhir
(Name of Parent)
Haryana, 121001
Haryana, 121004
gauravmehta.mrce@gmail.com
Sector-9
Manav Rachna College of Engineering
(GATE Paper code)
Communication Address
Graduated: No, Year of Graduation: 2013
Computer Science Engg./Technology
89012 42820
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. 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 2013. Further, if any suppression or distortion of facts is found after appearing
in the exam, any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.
Digital Fingerprint:
Faridabad
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.
Signature of Principal/ HOD
#1560
4.5 cm x 3.5 cm
Date: Seal
(For use as the eligibility certificate only for final year or backlog applicants)
Zonal GATE Office Contact
Chairman GATE
Indian Institute of Technology Delhi
Hauz Khas, New Delhi, 110016
d14eb2ca885449cd9231af9703bc04bc
Applicant's recent photograph
217 G 108 Y
GATE Exam Details
(Mobile No.)
(Exam City 2)
Principal Certificate
This is to certify that Dimpy Gambhir is a student enrolled in
Applicants signature inside the box in black ink Date: ....../....../............
India
She is a student of the final year of B.Tech.
Manav Rachna College of Engineering, Faridabad.
Faridabad
Application Form
Do not Attest
Do not sign on photo