Page 1 of 3 शिा ea=ky;] Hkkjr ljdkj ds v/khu ,d jk"Vªh; egRo dk la LFkku An Institute of National Importance under Ministry of Education, Govt. of India jk"Vªh; izkS|ksfxdh laLFkku iVuk@NATIONAL INSTITUTE OF TECHNOLOGY PATNA v'kksd jktiFk] iVuk] fcgkj @ ASHOK RAJPATH, PATNA – 800 005, BIHAR lanHkZ@Ref.:1169/Acad./20-21 fnukad@Date : 25/01/2021 NOTICE Information for Provisional Admission to PhD programme Ref: Institute notice no. 1099/Acad. /20-21 dt.: 05.01.2021 Candidates who have got seat for admission to PhD programmes at National Institute of Technology Patna for the academic year 2020-21 (Jan-June 2021 Semester) are required to follow the steps as given below: Activities to be followed in sequence Dates Step 1 Online Payment 26 to 28 Jan 2021, 5:00 PM Step 2 Provisional Admission 26 to 30 Jan 2021, 5:00 PM Step 3 Online Registration 29 to 30 Jan 2021, 5:00 PM Step 1: First you make online payment for Admission Fee through Link provided on Institute website. Step 2: i. Following forms of NIT Patna to be submitted (Form is attached with this notice) a. Admission Form b. Affidavit by the student regarding anti-ragging c. Affidavit by the parent/guardian regarding anti-ragging d. Medical Certificate should be issued from the registered Medical Practitioners/ Govt. Doctors e. Affidavit with respect to Gap year (i.e. reason for discontinuity between passing year of qualifying examination and year of admission to B. Tech/ B. Arch/ Master’s program.) f. Undertaking on non-judicial stamp paper of Rs. 100/- regarding refund of scholarship in the case of withdrawal from PhD program without completing (for Full time candidate only) ii. GATE Score card for Candidate with M. Tech./ M. E./ M. Arch/ M. Planning/ M. Design/M. Sc./M. Com./ MBA/ MA or equivalent degree / Valid GATE Score card for candidate with B.Tech/BE/B.Arch or equivalent degree (for Full Time candidate only) Tel No.: 0612-2371715 (Ext-166) Academic Section (शैिक अनुभाग)
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Examination Appeared (Attach proof) Registration No. Branch:
Admitted through (Selection authority details) Institute notice vide Acad. /20-21 dt.: 03.07.2020 Aadhaar No. /PAN No. (Attach Proof) Aadhar No.:
PAN No.:
Final allotted Branch/ Department/ Specialization
1. Name of candidate in full
(as per 10th Certificate)
Name of candidate in Devnagari (Hindi)
2. Father’s Name
3. Mother’s Name
4. Guardian’s name in full (if father is not alive)
5. Date of Birth (dd-mm-yy)/ Sex: Male/ Female
6. Occupation of Parents Father: Mother:
Parents Income per annum from all sources
Organization where father/ Mother is working or Guardian (if father is not alive)
7. Correspondence Address
Pin Code:
Phone No. (with STD Code)/ Mobile No.:
Email ID:
Page 2 of 3
8. Permanent Address:
Pin Code:
9. Academic Details:
Exam Branch/ Specialization Institute/ University Year of Passing
Matriculation/ 10th
Intermediate/ 12th
Bachelor’s level
Master’s Level
10. SGPA/ CGPA/ % Marks: SGPA CGPA % Marks Overall % Marks
Matriculation/ 10th (Fill in applicable column)
Intermediate/ 12th (Fill in applicable column)
Bachelor’s Degree: (Fill in applicable column)
2nd Sem/ 1st Yr
4th Sem/ 2nd Yr
6th Sem/ 3rd Yr
8th Sem/ 4th Yr
10th Sem/ 5th Yr
Master’s Degree 2nd Sem/ 1st Yr
4th Sem/ 2nd Yr
11. Declaration of the Candidate:
I,………………… ……………… ….…………………… Son/ Daughter of Sri………….…………………………
Declare that : -
a) Information furnished above are correct and in case any of the information is found false or forged at any stage of my admission to and/ or stay in the Institute, I shall be liable (i) to lose my candidature for admission to the program, (ii) for expulsion from the Institute if admitted and (iii) for appropriate legal action.
b) In the event of my being admitted to this Institution, I shall abide by all the rules and regulations of the Institute and the University, concerned.
c) I have submitted my qualifying examination passing certificate with the application form. OR
I will submit my qualifying examination passing certificate by the due date, else my admission shall stand cancelled. (Strike out whichever is not applicable)
Place : _________________
Full Signature of the Candidate in English Date : _________________
12. Declaration of the Father / Guardian: Candidates may submit the declaration of Father/ Guardian in their own handwriting separately even
after admission if Father/ Guardian is not available at the time of admission.
I,……………… ………………… …………… ………….. ………….(Name) declare that in the event of Sri/Smt./ Miss……………
…………………… ………….. …………..being admitted to this Institution. I shall be responsible for his / her conduct and
undertake to pay all his/ her Institute, Hostel, Mess and other dues regularly till the completion of his / her studies. I further
certify that the Information furnished by him/ her are correct.
Place :
Full Signature of Father / Guardian Date :
Page 3 of 3
Name of the candidate in full Roll No. (to be assigned by Receiving office)
1. Please verify the Self attested Photocopies of following:- (as applicable)
Mus
t be
subm
itted
at t
he ti
me
of A
dmis
sion
(Put mark)
(i) CCMT Reporting Letter and Allotment Letter
(ii) GATE Score Card (2018/2019/2020/other) (Put mark)
(iii) Certificate of Category OBC-NCL/ SC / ST, if applicable, Issued by the competent authority
(iv) Income Certificate for OBC Candidates for claim with respect to Non creamy Layer issued by competent authority/ as per directive of the MHRD. (If seat allotted in OBC-NCL category)
(v) Certificate for Person with Disabilities/ Physically handicapped
(vi) Class X (High School) Board Certificate as proof of Date of Birth
(vii) Matriculation (10th)) Marks Sheet
(viii) Qualifying Examination Marks Sheet/ Grade Card: (Strike out whichever is not applicable)
Intermediate (12th ) Marks Sheet
B. Tech/ B.E./ B. Arch. Or equivalent
M.Tech/M.E/M.Arch/MURP or equivalent
(ix) Qualifying Examination passing certificate (as applicable for the program). In case it is not being submitted then undertaking for submission by due date fixed by Institute.
(x) Affidavit with respect to Gap year (i.e. reason for discontinuity between passing year of qualifying examination and year of admission to B. Tech/ B. Arch/ B.E./ M.Tech/M.E/M.Arch/MURP or equivalent)
(xi) Four copies of Photograph. (identical to one Pasted on the application form)
(xii) No. Objection certificate from parent employer (if applicable)
(xiii) Certificate of sponsorship (if applicable)
(xiv) Migration Certificate from the University/ Deemed University / Institute last Attended
(xv) Conduct Certificate from the University/ Deemed University / Institute/school last Attended
(xvi) Proof of Payment for Admission Fee as per Information Brochure/ program
(xvii) Affidavit by the student regarding anti-ragging
(xviii) Affidavit by the parent/guardian regarding anti-ragging
(xix) Undertaking on stamp paper of Rs. 100/- or more regarding refund of scholarship in the case of M.Tech/MURP/M.Arch
(xx) Medical Certificate should be issued from the registered Medical Practitioners/ Govt. Doctors
2. Signature of documents Verifying Officer(s) with Date:
1………………..….. 2………………….…….. 3………….………..
(To be obtained at the time of admission in presence of Institute representative only)
3. Full Signature of the Candidate: (English)
Left Thumb impression of the Candidate
Signature of Admission-In-Charge of the Department/ Institute
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AFFIDAVIT BY THE STUDENT
(On non-judicial stamp paper of Rs.100/- or more)
I, _____________ ___________________________ _________________ (full name of student with
admission/ registration/ enrolment number) s/o d/o Mr./Mrs./Ms. _______ ____ ________ _______________ _________________ , having been admitted to National Institute of Technology Patna (name of the
institution) , have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the “Regulations”) carefully read and fully understood the provisions contained in the said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative action that is liable to be taken against me in case I am found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) I will not indulge in any behavior or act that may be constituted as ragging under clause 3 of the Regulations.
b) I will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against me under any penal law or any law for the time being in force.
6) I hereby declare that I have not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is liable to be cancelled.
Declared this ___day of __________ month of ______year.
_________________________ Signature of deponent
Name: __________ __________ ___________
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein.
Verified at ____________ (place) on this the _____ (day) of_______ (month) , _________ (year ) .
________________ Signature of deponent
Solemnly affirmed and signed in my presence on this the (day) of (month), (year) after reading the contents of this affidavit.
OATH COMMISSIONER
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AFFIDAVIT BY PARENT/GUARDIAN (On non-judicial stamp paper of Rs.100/- or more)
I, Mr./Mrs./Ms. _________________ __________________ __________________ (full name of
parent/guardian) father/ mother/ guardian of , __________ ________ _______ _______ ____ (full name of
student with admission/ registration/ enrolment number) , having been admitted to National Institute of
Technology Patna (name of the institution) , have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the “Regulations”), carefully read and fully understood the provisions contained in the said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative action that is liable to be taken against my ward in case he/she is found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) My ward will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the Regulations.
b) My ward will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against my ward under any penal law or any law for the time being in force.
6) I hereby declare that my ward has not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be untrue, the admission of my ward is liable to be cancelled.
Declared this ____ day of __________ month of _______ year.
_____________________ Signature of deponent
Name: __________________________________________ Address:_________________________________________ Telephone/ Mobile No.: ____________________________
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein.
Verified at __________ (place) on this the ___ (day) of _________ (month) , __________ (year ) .
____________ ________________ Signature of deponent
Solemnly affirmed and signed in my presence on this the ___ (day) of ________ (month) __________ (year ) after reading the contents of this affidavit.
OATH COMMISSIONER
To
The Notary Public
--------------------------
A f f i d a v i t f o r G a p Y e a r
I _______________________________________________________________