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Zone/Scrutiny Code
6CD
To
GATE 2013
Chairman GATE Indian Institute of Technology Kharagpur Kharagpur, 721302
132 K 517 E
96923 29781
(Mobile No.)
Cut Here
Note: Application ID - 132 K 517 E. You should preserve this number for further correspondence.
Zone/Scrutiny Code
6CD
132 K 517 E
(Full Name of Applicant)
4.5 cm x 3.5 cm
(Application ID)
01 Feb 1977
(D.O.B)
Male
Debaraj Sahu
(Name of Parent)
GEN
Indian National
Communication Address
Late Debaraj sahu at-jiura po-gangapur via-pattapur (ganjam) Orissa, 761013 India
Bhubaneswar, OR
(Exam City 1)
Berhampur, OR
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.E. Mechanical Engg. Graduated: Yes, Year of Graduation: 2001 G.I.E.T GUNUPUR GUNUPUR Orissa, 765022
Enclosure Checklist
Eligibility Certificate copy Stamped Bank Challan: GATE copy
Payment Details
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.
Date: ....../....../............