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Instrumentation EngineeringSUKUMAR PAULName of the Candidate as inthe 10th Class Certificate
Choice of GATE Paper1. 9.
GATE COPYAPPLICATION NO. 6003074
GATE 2012 APPLICATION FORM
Zone: IIT Kharagpur Payment Mode: Bank Challan (SBI) Fee: Rs. 1000
Date of Birth (DD/MM/YYYY)2. E-mail Address [email protected]/10/1987 10.
Gender3. MALE Address for Correspondence SECTOR-12/E11.
QUARTER NUMBER-1259
BOKARO STEEL CITY
JHARKHAND
Category
Person with Disability (PD)
Nationality
Year of Degree
Discipline
5.
6.
4.
13.
14.
OBC(Non-Creamy Layer)
No
INDIAN
2012
Instrumentation / Electronics /Control
PINCODE of Address forCorrespondence
12. 827012
Qualifying Degree
Choice of Examination City1
Choice of Examination City2
Name of Parent
State/Union Territory ofPermanent Residence
7.
8.
15.
16.B.E./B.Tech./ B.Sc.(Engg.)/B.Sc.(Tech.)/B.Arch.
611 - Kolkata
615 - Ranchi
SHYAM PAD PAUL
Jharkhand
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge andbelief. I have read the contents of GATE 2012 website and I shall abide by the terms and conditions therein. Inthe event of suppression or distortion of any fact in my application form, I understand that I will be denied theopportunity to appear in GATE 2012 Further if any such suppression or distortion of facts is found after
Mobile / Landline No.17. 09681108216
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Instrumentation EngineeringSUKUMAR PAULName of the Candidate as inthe 10th Class Certificate
Choice of GATE Paper1. 9.
CANDIDATE COPYAPPLICATION NO. 6003074
GATE 2012 APPLICATION FORM
Zone: IIT Kharagpur Payment Mode: Bank Challan (SBI) Fee: Rs. 1000
Date of Birth (DD/MM/YYYY)2. E-mail Address [email protected]/10/1987 10.
Gender3. MALE Address for Correspondence SECTOR-12/E11.
QUARTER NUMBER-1259
BOKARO STEEL CITY
JHARKHAND
Category
Person with Disability (PD)
Nationality
Year of Degree
Discipline
5.
6.
4.
13.
14.
OBC(Non-Creamy Layer)
No
INDIAN
2012
Instrumentation / Electronics /Control
PINCODE of Address forCorrespondence
12. 827012
Qualifying Degree
Choice of Examination City1
Choice of Examination City2
Name of Parent
State/Union Territory ofPermanent Residence
7.
8.
15.
16.B.E./B.Tech./ B.Sc.(Engg.)/B.Sc.(Tech.)/B.Arch.
611 - Kolkata
615 - Ranchi
SHYAM PAD PAUL
Jharkhand
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge andbelief. I have read the contents of GATE 2012 website and I shall abide by the terms and conditions therein. Inthe event of suppression or distortion of any fact in my application form, I understand that I will be denied theopportunity to appear in GATE 2012 Further if any such suppression or distortion of facts is found after
Mobile / Landline No.17. 09681108216
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To
BY SPEED / REGISTERED POST(Please do not Courier)
Chairman, GATE
GATE 2012 Application Form
Indian Institute of Technology Kharagpur
From
SUKUMAR PAUL (APPLNO : 6003074)
SECTOR-12/E
Kharagpur - 721302
Do not tamper with the bar code. For GATE official use.
QUARTER NUMBER-1259
BOKARO STEEL CITY
JHARKHAND
827012
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OBC(Non-Creamy Layer)OBC(Non-Creamy Layer)OBC(Non-Creamy Layer)
[email protected]@[email protected]
096811082160968110821609681108216
SECTOR-12/E QUARTER NUMBER-1259
BOKARO STEEL CITY JHARKHAND - 827012
SECTOR-12/E QUARTER NUMBER-1259
BOKARO STEEL CITY JHARKHAND - 827012
SECTOR-12/E QUARTER NUMBER-1259
BOKARO STEEL CITY JHARKHAND - 827012
SUKUMAR PAULSUKUMAR PAULSUKUMAR PAUL
1. Please note to write the Journal Number in all the challans.2. Please feed the Application No. in REG/ID/Ref No. Column.
SEAL / DATE AUTHORISED SIGNATORY
E Mail ID :
Category :
Address forCorrespondence :
02/10/1987
Mobile / Landline No:
CASH VOUCHER BANK COPY
GATE 2012 Application Fee Payment Challan
Name of the Candidate :
Signature of the Candidate/Remitter
For Receiving Branch use only
Registration ID / Ref No. : 6003074
Category :
CASH VOUCHER
JOURNAL NUMBER
For Receiving Branch use only
Signature of the Candidate/Remitter
E Mail ID :
Address forCorrespondence :
Mobile / Landline No:
GATE 2012 Application Fee Payment Challan
Category :
CASH VOUCHER
For Receiving Branch use only
Signature of the Candidate/Remitter
E Mail ID :
Address forCorrespondence :
Mobile / Landline No:
GATE 2012 Application Fee Payment Challan
GATE COPY CANDIDATE COPY
CASH CAN BE TENDERED AT ANY SBI BRANCH
Use CBS Screen No. :
FEE Type :
Date of Birth :
16
8888
Amount :
Amount in words :
Rs.1025/- *
Rupees One thousand and Twenty Five Only.(*Application Fees Including Bank Charges)
CASH CAN BE TENDERED AT ANY SBI BRANCH
Amount :
Amount in words :
Rs.1025/- *
Rupees One thousand and Twenty Five Only.(*Application Fees Including Bank Charges)
JOURNAL NUMBER
Name of the Candidate :
02/10/1987
Registration ID / Ref No. : 6003074
Use CBS Screen No. :
FEE Type :
Date of Birth :
16
8888
1. Please note to write the Journal Number in all the challans.2. Please feed the Application No. in REG/ID/Ref No. Column.
SEAL / DATE AUTHORISED SIGNATORY
1. Please note to write the Journal Number in all the challans.2. Please feed the Application No. in REG/ID/Ref No. Column.
SEAL / DATE AUTHORISED SIGNATORY
JOURNAL NUMBER
Rs.1025/- *
Rupees One thousand and Twenty Five Only.(*Application Fees Including Bank Charges)
Amount :
Amount in words :
Name of the Candidate :
02/10/1987
Registration ID / Ref No. : 6003074
Use CBS Screen No. :
FEE Type :
Date of Birth :
16
8888
CASH CAN BE TENDERED AT ANY SBI BRANCH
Challan can be deposited minimum one day after thegeneration of challan.
Challan can be deposited minimum one day after thegeneration of challan.
Challan can be deposited minimum one day after thegeneration of challan.
Last date for acceptanceof challan in bank : 24 October 2011.
Last date for acceptanceof challan in bank : 24 October 2011.
Last date for acceptanceof challan in bank : 24 October 2011.
