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Information Brochure B.Tech Admission 2019-20 Indian Institute of Technology Tirupati Renigunta Road, Tirupati – 517 506 1

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Page 1: Information Brochure B.Tech Admission 201 9-20 › pdfs › Information Brochure-2019-20.pdfproficiency in English so that they can understand lectures, communicate with fellow students

Information Brochure B.Tech Admission 2019-20

Indian Institute of Technology Tirupati Renigunta Road, Tirupati – 517 506

1

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI Renigunta Road, Tirupati – 517 506

Dear Student, Greetings and good wishes to you on behalf of the IIT Tirupati.

We warmly welcome you to IIT Tirupati and congratulate you for getting admission into one of India’s most prestigious higher technical Institutions. We wish to make your experience most fulfilling and wonderful phase in your life.

Schedule of activities:

Date Event Venue

24-07-2019 (Wednesday)

Reporting for Hostel Admission

For Boys Boys Hostel, IIT Tirupati Permanent Campus, Yerpedu, Yerpedu – Venkatagiri Road, (1.5 Kms from Yerpedu Main Junction). Contact persons: Mr. Vasudeva Rao - 8333904913 Mr. Janakiraman – 8333987911

For Girls Girls Hostel, IIT Tirupati Permanent Campus, Yerpedu, Yerpedu – Venkatagiri Road, Yerpedu (1.5 Kms from Yerpedu Main Junction). Contact person: Ms. Fathima Azra Fazal – 9493707597

25-07-2019 (Thursday)

Orientation Program & Document Verification

Academic Building, IIT Tirupati (Permanent Campus), Yerpedu-Venkatagiri Road.

26-07-2019 (Friday)

to 30-07-2019 (Tuesday)

Induction Program Academic Building, IIT Tirupati (Permanent Campus), Yerpedu-Venkatagiri Road.

31-07-2019 (Wednesday)

Introduction to Faculty Advisors and Course Registration

Academic Building, IIT Tirupati (Permanent Campus), Yerpedu-Venkatagiri Road.

01-08-2019 (Thursday)

Commencement of Classes

Academic Building, IIT Tirupati (Permanent Campus), Yerpedu-Venkatagiri Road.

The last date for enrolment with fine of Rs. 2000/- is 06-08-2019

Students should produce the following documents in original for verification during Admission on 25.07.2019 (Thursday):

a) Provisional Admission letter b) Original Admit Card JEE (Advanced) 2019 c) Original Certificate of Date of Birth, 10th class and 12th class or equivalent d) If you belong to DS/SC/ST/OBC-NCL/EWS category or PwD, the category and/or PwD certificate as

per the format in the JoSAA portal. e) The students belonging to most economically backward (whose family income is less than Rs. 1.00

lakh per annum) and other economically backward (whose family income is between Rs.1.00 lakh and Rs.5.00 lakhs per annum) have to obtain Income certificate in the Form A/B (Annexure III) and apply for the fee remission in the prescribed Form (Annexure VII) and submit the same in original for verification at the time of admission i.e., on 25.07.2019 failing which they are not eligible for Tuition fee concession as indicated in the fee structure.

[P.T.O]

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Students should submit the following at the time of admission:

a) Scholarship application form [MCM Scholarship (Annexure IV A) or SC/ST Scholarship (Annexure IV B)] along with income certificate Form A/B (if eligible).

b) Medical Examination Report (Annexure V) – Test reports not required c) Solemn Affirmation of conformance to rules and regulations, Anti-ragging Self and Parent declaration

(Annexure VI) d) Transaction details for online fee payment e) Student datasheet form (Annexure VIII)

As you may be aware, English is the sole medium of instruction and examination here, just as it is at other educational institutions offering professional courses. Students are expected to have a certain level of proficiency in English so that they can understand lectures, communicate with fellow students and others, and engage in regular academic pursuits.

To identify students in need of a basic level course in English, a Diagnostic Test will be conducted. This is a compulsory test for all those joining the B.Tech Programme. Based on their performance, students in need of basic level English will be identified and given a suitable course in the first semester.

The Diagnostic Test may include tests of grammar, vocabulary, reading and listening comprehension and related writing such as essays.

Those who cleared the Diagnostic Test will be taking some other language course in the first Semester.

Please bring one set of khaki uniform (Pant & Shirt for Boys and Over coat for Girls) and shoes during workshop practical class.

We look forward meeting you and your parents/guardian at the time of orientation on 25-07-2019.

With best wishes Prof. K. Krishnaiah

Professor I/C, Academic Affairs

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Indian Institute of Technology Tirupati Renigunta Road, Tirupati – 517 506

Fee Structure – B.Tech (2019 Batch) First Semester (July-Dec 2019)

S.No Item of Fee & Deposits Value in Rs.

I. Institute Fees

SC/ST/

PwD

Income

Above 5

Lakhs

Income

between 1

to 5 Lakhs

Income

below 1

Lakh

A. One Time Fees (during admission)

1. Admission fee 150 150 150 150

2. Grade card fee 150 150 150 150

3. Provisional certificate 100 100 100 100

4. Medical Exam fee 100 100 100 100

5. Student welfare fund 1000 1000 1000 1000

6. Modernization fee 300 300 300 300

7. Alumni Life Membership Fee (NS) 1000 1000 1000 1000

8. Publication Fee (NS) 250 250 250 250

Total A 3050 3050 3050 3050

B. Semester Fees

1. Tuition Fee 0 100000 33334 0

2. Examination Fee 350 350 350 350

3. Registration – Enrolment Fee 200 200 200 200

4. Gymkhana Fee 1250 1250 1250 1250

5. Medical Fee 700 700 700 700

6. Student Wellness Fee 100 100 100 100

7. Medical Insurance Premium 1400 1400 1400 1400 8. Hostel Seat Rent * 5000 5000 5000 5000

9. Fan, Electricity & Water charges * 750 750 750 750

Total B 9750 109750 43084 9750

C. Deposits (refundable)

1. Institute Deposit 1000 1000 1000 1000

2. Library Deposit 1000 1000 1000 1000

Total C 2000 2000 2000 2000

Total Institute Fee for Hostellers (A+B+C) 14800 114800 48134 14800

Total Institute Fee for Day-Scholars [A+(B-*)+C+II(3)] 15050 115050 48384 15050

II. Hostel & Mess Charges for GE/OBC/EWS and SC/ST/PwD

1. Admission Fee 250

2. Hostel Deposit (NS)-(refundable) 3000

3. Estt. “A” Charges 6000

4. Estt. “B” Charges 1500

5. SWD 50

6. Advanced Dinning charges 19800

Total 30600

NS - Non-Statutory fees

* - For Hostellers only

All the eligible students shall have access to interest free loan under Vidyalaxmi scheme

Hostel rooms are allotted on sharing basis. If you wish to be a day scholar, you should register your name in

the Office of the Associate Dean of Students and obtain day scholar certificate immediately after admission.

Annexure IA

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI

Renigunta Road, Tirupati – 517 506

Details of fee payable various categories of students

S.No Fee Particulars

Institute Fee Hostel

Fee Due Hosteller Day Scholar

Total Due Total Due

(1) (2) (3) (4) (5) (6) (7)

1 SC/ST/PwD Students 14800 1300 15050 1550 30600

2

Most economically backward

students (whose family income is

less than 1 lakh per annum)

14800 (-) 18700 15050 (-) 18450 30600

3

Other economically backward

students (whose family income is

1 lakh to 5 lakh per annum)

48134 14634 48384 14884 30600

4 All other students (whose family

income above 5 lakhs per annum) 114800 81300 115050 81550 30600

Seat acceptance fee of Rs.13500/- (SC/ST/PwD) and Rs.33500/- (for others) has already been paid*.

The balance fee to be paid is shown in column number (4) and (6) of above table. Extra payment made

by the students as shown in column number (4) and (6) with minus (-) sign will be credited to the

student’s bank account after admission.

* Rs.1500/- deducted towards processing fee for document verification at reporting centre.

Note: Candidates can pay the fee online with effect from 19-07-2018 onwards.

Annexure I B

5

Fees should be paid only through online. DD is not acceptable.

Fee payment link: https://easypay.axisbank.co.in/easyPay/makePayment?mid=MzY5ODg%3D

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI

Renigunta Road, Tirupati – 517 506

Statement of Expenditure for B.Tech Programme

(Students’ whose family income is above 5 lakhs per annum)

The following statement of expenditure is issued to facilitate for availing Bank Loan/Scholarship.

Fees and Statement of Expenditure for B.Tech. Programme and other charges/expenses for the

students to be admitted in the Academic year 2019-20.

S.No Particulars Value in

Rs.

1. Admission/1st semester fee (including insurance) 1,12,800

2. Caution deposit (Institute & Library) 2,000

3. Fees payable from 2nd to 8th Semester @ Rs. 1,08,350 x 7 7,58,450

4. Annual Medical Insurance Premium for 3 years at the rate of Rs. 1400/- * 4,200

5. Hostel Caution Deposit 3,000

6. Hostel Admission Fee @ Rs. 250/- per semester for 8 semesters 2,000

7. Hostel Establishment ‘A’ charges @ Rs. 6,000/- per semester for 8 semesters* 48,000

8. Hostel Establishment ‘B’ charges @ Rs. 1,500/- per semester for 8 semesters* 12,000

9. Solid Waste Disposal charges @ Rs.50/- per semester for 8 semesters 400

10. Text books & stationery (approx..) 40,000

11. Laptop computer 1,00,000

12. Boarding & Lodging charges for 4 years* 1,60,000

Total 12,42,850

13. Semester abroad programmes** 4,00,000

Grand Total 16,42,850

* For budgetary purposes, calculations are based on rate during current academic year 2019-20 and for

subsequent years, a nominal increase in charges have been accounted for.

** A few students who are academically performing well are permitted by the Institute to pursue one or

two semesters in a foreign University with which IIT Tirupati has an MoU for doing courses and or project.

Specific permission letter will be given by Dean Academic Affairs in these cases. Student may be permitted

to avail this additional loan provision with the production of: (i) Letter of permission from host University

and (ii) Letter of permission from the respective Dean Academic Affairs of IIT Tirupati.

Academic Section

Annexure II A

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI

Renigunta Road, Tirupati – 517 506

Statement of Expenditure for B.Tech Programme

(Students’ whose family income between Rs.1 Lakh to Rs.5 Lakhs per annum)

The following statement of expenditure is issued to facilitate for availing Bank Loan/Scholarship.

Fees and Statement of Expenditure for B.Tech. Programme and other charges/expenses for the

students to be admitted in the Academic year 2019-20.

S.No Particulars Value in

Rs.

1. Admission/1st semester fee (including insurance) 46,134

2. Caution deposit (Institute & Library) 2,000

3. Fees payable from 2nd to 8th Semester @ Rs. 41,684 x 7 2,91,788

4. Annual Medical Insurance Premium for 3 years at the rate of Rs. 1400/- * 4,200

5. Hostel Caution Deposit 3,000

6. Hostel Admission Fee @ Rs. 250/- per semester for 8 semesters 2,000

7. Hostel Establishment ‘A’ charges @ Rs. 6,000/- per semester for 8 semesters* 48,000

8. Hostel Establishment ‘B’ charges @ Rs. 1,500/- per semester for 8 semesters* 12,000

9. Solid Waste Disposal charges @ Rs.50/- per semester for 8 semesters 400

10. Text books & stationery (approx..) 40,000

11. Laptop computer 1,00,000

12. Boarding & Lodging charges for 4 years* 1,60,000

Total 7,09,522

13. Semester abroad programmes** 4,00,000

Grand Total 11,09,522

* For budgetary purposes, calculations are based on rate during current academic year 2019-20 and for

subsequent years, a nominal increase in charges have been accounted for.

** A few students who are academically performing well are permitted by the Institute to pursue one or

two semesters in a foreign University with which IIT Tirupati has an MoU for doing courses and or project.

Specific permission letter will be given by Dean Academic Affairs in these cases. Student may be permitted

to avail this additional loan provision with the production of: (i) Letter of permission from host University

and (ii) Letter of permission from the respective Dean Academic Affairs of IIT Tirupati.

Academic Section

Annexure II B

7

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI

Renigunta Road, Tirupati – 517 506

Statement of Expenditure for B.Tech Programme

(Students’ whose family income is below Rs.1 Lakh per annum)

The following statement of expenditure is issued to facilitate for availing Bank Loan/Scholarship.

Fees and Statement of Expenditure for B.Tech. Programme and other charges/expenses for the

students to be admitted in the Academic year 2019-20.

S.No Particulars Value in

Rs.

1. Admission/1st semester fee (including insurance) 12,800

2. Caution deposit (Institute & Library) 2,000

3. Fees payable from 2nd to 8th Semester @ Rs. 8,350 x 7 58,450

4. Annual Medical Insurance Premium for 3 years at the rate of Rs. 1400/- * 4,200

5. Hostel Caution Deposit 3,000

6. Hostel Admission Fee @ Rs. 250/- per semester for 8 semesters 2,000

7. Hostel Establishment ‘A’ charges @ Rs. 6,000/- per semester for 8 semesters* 48,000

8. Hostel Establishment ‘B’ charges @ Rs. 1,500/- per semester for 8 semesters* 12,000

9. Solid Waste Disposal charges @ Rs.50/- per semester for 8 semesters 400

10. Text books & stationery (approx..) 40,000

11. Laptop computer 1,00,000

12. Boarding & Lodging charges for 4 years* 1,60,000

Total 4,42,850

13. Semester abroad programmes** 4,00,000

Grand Total 8,42,850

* For budgetary purposes, calculations are based on rate during current academic year 22019-20 and for

subsequent years, a nominal increase in charges have been accounted for.

** A few students who are academically performing well are permitted by the Institute to pursue one or

two semesters in a foreign University with which IIT Tirupati has an MoU for doing courses and or project.

Specific permission letter will be given by Dean Academic Affairs in these cases. Student may be permitted

to avail this additional loan provision with the production of: (i) Letter of permission from host University

and (ii) Letter of permission from the respective Dean Academic Affairs of IIT Tirupati.

Academic Section

Annexure II C

8

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI

Renigunta Road, Tirupati – 517 506

Statement of Expenditure for B.Tech Programme

(All SC, ST, PwD students’ irrespective of parental Income)

The following statement of expenditure is issued to facilitate for availing Bank Loan/Scholarship.

Fees and Statement of Expenditure for B.Tech. Programme and other charges/expenses for the

students to be admitted in the Academic year 2019-20.

S.No Particulars Value in

Rs.

1. Admission/1st semester fee (including insurance) 12,800

2. Caution deposit (Institute & Library) 2,000

3. Fees payable from 2nd to 8th Semester @ Rs. 8,350 x 7 58,450

4. Annual Medical Insurance Premium for 3 years at the rate of Rs. 1400/- * 4,200

5. Hostel Caution Deposit 3,000

6. Hostel Admission Fee @ Rs. 250/- per semester for 8 semesters 2,000

7. Hostel Establishment ‘A’ charges @ Rs. 6,000/- per semester for 8 semesters* 48,000

8. Hostel Establishment ‘B’ charges @ Rs. 1,500/- per semester for 8 semesters* 12,000

9. Solid Waste Disposal charges @ Rs.50/- per semester for 8 semesters 400

10. Text books & stationery (approx..) 40,000

11. Laptop computer 1,00,000

12. Boarding & Lodging charges for 4 years* 1,60,000

Total 4,42,850

13. Semester abroad programmes** 4,00,000

Grand Total 8,42,850

* For budgetary purposes, calculations are based on rate during current academic year 2019-20 and for

subsequent years, a nominal increase in charges have been accounted for.

** A few students who are academically performing well are permitted by the Institute to pursue one or

two semesters in a foreign University with which IIT Tirupati has an MoU for doing courses and or project.

Specific permission letter will be given by Dean Academic Affairs in these cases. Student may be permitted

to avail this additional loan provision with the production of: (i) Letter of permission from host University

and (ii) Letter of permission from the respective Dean Academic Affairs of IIT Tirupati.

Academic Section

Annexure II D

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FORM A

INCOME CERTIFICATE FROM THE HEAD OF THE OFFICE WHERE FATHER AND/ OR MOTHER /GUARDIAN OF THE STUDENT IS EMPLOYED

(This certificate is to be produced by Father /Mother /Guardian who are working in Government/ Public sector organisation.)

Certified that the annual income of Shri / Smt. _____________________________________

(Father / Mother / Guardian) employed in this office as ______________________________

including special pay, etc. during the year 2018-2019 (July 2018–June 2019) is as given below:

Sl. No. Item Total in (July 2018 to June 2019)

1 Basic Pay (including special pay, NPA etc.)

2 D.A.

3 C.C.A.

4 Deputation allowance

5 Special Pay

6 Honorarium

7 Bonus

8 Other allowances, if any

Total

Place : Signature of the Head Office / Department Date :

(This certificate is not valid without the office seal) Note: Separate certificate has to be given for father & mother

(if father and mother are employed)

Annexure III

10

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FORM B

INCOME CERTIFICATE FROM THE REVENUE OFFICIAL NOT BELOW THE RANK OF THASILDAR OR MAGISTRATE CLASS I OF THE AREA WHERE THE

FATHER AND/OR MOTHER/LEGAL GUARDIAN OF THE STUDENT RESIDES

(This certificate is to be produced by Father /Mother /Guardian who are self-employed as Doctor/ Lawyer/Businessman/Agriculturist/Private employment, etc.)

Certified after having fully satisfied myself that the income of

Shri/Smt._________________________________________ Father/ Mother/ Guardian of the

student residing at ___________________________________________________________

______________________________is ______________ for the period from July 2018 to

June 2019 as detailed below:

Sl.No. Item Total Annual Income in `. (July 2018 to June 2019)

1 Professional Income (Doctor, Lawyer, etc.)

2 Agricultural Income

3 Interest from Bank deposits

4 Dividend from shares

5 Other income (give details such as House rent income etc.)

Total

Signature of Father :

Mother :

Date : Signature of the Revenue Official Not below the rank of Tahsildar/ Magistrate Class I

Place :

(This certificate is not valid without the official seal) Note : Separate certificate has to be given for father and mother if both have separate

sources of income.

11

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI APPLICATION FORM FOR MCM SCHOLARSHIP

(This form is to be filled in by B.Tech students whose parents’ annual income is less than Rs.4.50 lakhs during July 2018 to June 2019)

1. Name of the student (in block letters) :

Roll No. :

Hostel Address :(If day scholar, give present address)

2. Category : GE / OBC / EWS / PwD-GE/ PwD-OBC (enclose copy of certificates if any)

3. Date of Birth :

4. Place, District and State of birth :

5. Permanent address :

6. Parent’s Occupation (Please tick whichever is applicable)

Sl.No Job Father Mother Guardian

1 Govt. job / Company job

2 Self-employment : Lawyer/Doctor/ Business/ Agriculture, etc.

Parent’s Mobile No. :

Student Mobile No & e-mail ID :

Contd….

Annexure IV A

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7. Income in Rupees:

Sl.No Income thro’ Father Mother Guardian

1 Salary/Pension

2 Self-employment: Profession/ Business/ Agriculture/ Others (specify)

3 Other Income: Rent/Interest on Investment, etc.

The above income must be authenticated as follows: • Salary/Pension – Employer’s certificate in Form A has to be given (If father and

Mother are employed, two separate certificate have to be given) • Agriculture / House Income / Business/Consultancy / Doctor / Lawyer /

Professional Practice – Thasildar’s certificate in Form B has to be given

8. Have you applied for (or) getting any other Scholarship : Yes / No

If yes, from which Organisation ? :

What is the amount per annum : `.

We hereby declare and affirm that the above statement made by us is correct to the best of our knowledge. In case any of the particulars furnished by us are found to be incorrect at a later date, we will be liable to refund the scholarship amount already received.

(Signature of the Parent) (Signature of the Student)

Place : Date :

STUDENT UNDERTAKING

Certified that Shri/Ms Roll No. ------------------ is not in receipt of Scholarship from any other sources.

Date Signature Name : Hostel & Room No :

13

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FORM A

INCOME CERTIFICATE FROM THE HEAD OF THE OFFICE WHERE FATHER AND/ OR MOTHER /GUARDIAN OF THE STUDENT IS EMPLOYED

(This certificate is to be produced by Father /Mother /Guardian who are working in Government/ Public sector organisation.)

Certified that the annual income of Shri / Smt. _____________________________________

(Father / Mother / Guardian) employed in this office as ______________________________

including special pay, etc. during the year 2018-2019 (July 2018–June 2019) is as given below:

Sl. No. Item Total in (July 2018 to June 2019)

1 Basic Pay (including special pay, NPA etc.)

2 D.A.

3 C.C.A.

4 Deputation allowance

5 Special Pay

6 Honorarium

7 Bonus

8 Other allowances, if any

Total

Place : Signature of the Head Office / Department Date :

(This certificate is not valid without the office seal) Note: Separate certificate has to be given for father & mother

(if father and mother are employed)

14

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FORM B

INCOME CERTIFICATE FROM THE REVENUE OFFICIAL NOT BELOW THE RANK OF THASILDAR OR MAGISTRATE CLASS I OF THE AREA WHERE THE

FATHER AND/OR MOTHER/LEGAL GUARDIAN OF THE STUDENT RESIDES

(This certificate is to be produced by Father /Mother /Guardian who are self-employed as Doctor/ Lawyer/Businessman/Agriculturist/Private employment, etc.)

Certified after having fully satisfied myself that the income of

Shri/Smt._________________________________________ Father/ Mother/ Guardian of the

student residing at ___________________________________________________________

______________________________is ______________ for the period from July 2018 to

June 2019 as detailed below:

Sl.No. Item Total Annual Income in `. (July 2018 to June 2019)

1 Professional Income (Doctor, Lawyer, etc.)

2 Agricultural Income

3 Interest from Bank deposits

4 Dividend from shares

5 Other income (give details such as House rent income etc.)

Total

Signature of Father :

Mother :

Date : Signature of the Revenue Official Not below the rank of Tahsildar/ Magistrate Class I

Place :

(This certificate is not valid without the official seal) Note : Separate certificate has to be given for father and mother if both have separate

sources of income.

15

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI APPLICATION FORM FOR SC/ST SCHOLARSHIP

(This form is to be filled in by B.Tech students whose parents’ annual income is less than Rs.4.50 lakhs during July 2018 to June 2019)

1. Name of the student (in block letters) :

Roll No. :

Hostel Address :(If day scholar, give present address)

2. Category : SC / ST / PwD-SC/ PwD-ST (enclose copy of certificates if any)

3. Date of Birth :

4. Place, District and State of birth :

5. Permanent address :

6. Parent’s Occupation (Please tick whichever is applicable)

Sl.No Job Father Mother Guardian

1 Govt. job / Company job

2 Self-employment : Lawyer/Doctor/ Business/ Agriculture, etc.

Parent’s Mobile No. :

Student Mobile No & e-mail ID :

Contd….

Annexure IV B

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- 2 -

7. Income in Rupees:

Sl.No Income thro’ Father Mother Guardian

1 Salary/Pension

2 Self-employment: Profession/ Business/ Agriculture/ Others (specify)

3 Other Income: Rent/Interest on Investment, etc.

The above income must be authenticated as follows: • Salary/Pension – Employer’s certificate in Form A has to be given (If father and

Mother are employed, two separate certificate have to be given) • Agriculture / House Income / Business/Consultancy / Doctor / Lawyer /

Professional Practice – Thasildar’s certificate in Form B has to be given

8. Have you applied for (or) getting any other Scholarship : Yes / No

If yes, from which Organisation ? :

What is the amount per annum : `.

We hereby declare and affirm that the above statement made by us is correct to the best of our knowledge. In case any of the particulars furnished by us are found to be incorrect at a later date, we will be liable to refund the scholarship amount already received.

(Signature of the Parent) (Signature of the student)

Place : Date :

STUDENT UNDERTAKING

Certified that Shri/Ms. Roll No. ------------------ is not in receipt of Scholarship from any other sources.

Date Signature : Name : Hostel & Room No :

17

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FORM A

INCOME CERTIFICATE FROM THE HEAD OF THE OFFICE WHERE FATHER AND/ OR MOTHER /GUARDIAN OF THE STUDENT IS EMPLOYED

(This certificate is to be produced by Father /Mother /Guardian who are working in Government/ Public sector organisation.)

Certified that the annual income of Shri / Smt. _____________________________________

(Father / Mother / Guardian) employed in this office as ______________________________

including special pay, etc. during the year 2018-2019 (July 2018–June 2019) is as given below:

Sl. No. Item Total in (July 2018 to June 2019)

1 Basic Pay (including special pay, NPA etc.)

2 D.A.

3 C.C.A.

4 Deputation allowance

5 Special Pay

6 Honorarium

7 Bonus

8 Other allowances, if any

Total

Place : Signature of the Head Office / Department Date :

(This certificate is not valid without the office seal) Note: Separate certificate has to be given for father & mother

(if father and mother are employed)

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FORM B

INCOME CERTIFICATE FROM THE REVENUE OFFICIAL NOT BELOW THE RANK OF THASILDAR OR MAGISTRATE CLASS I OF THE AREA WHERE THE

FATHER AND/OR MOTHER/LEGAL GUARDIAN OF THE STUDENT RESIDES

(This certificate is to be produced by Father /Mother /Guardian who are self-employed as Doctor/ Lawyer/Businessman/Agriculturist/Private employment, etc.)

Certified after having fully satisfied myself that the income of

Shri/Smt._________________________________________ Father/ Mother/ Guardian of the

student residing at ___________________________________________________________

______________________________is ______________ for the period from July 2018 to

June 2019 as detailed below:

Sl.No. Item Total Annual Income in `. (July 2018 to June 2019)

1 Professional Income (Doctor, Lawyer, etc.)

2 Agricultural Income

3 Interest from Bank deposits

4 Dividend from shares

5 Other income (give details such as House rent income etc.)

Total

Signature of Father :

Mother :

Date : Signature of the Revenue Official Not below the rank of Tahsildar/ Magistrate Class I

Place :

(This certificate is not valid without the official seal) Note : Separate certificate has to be given for father and mother if both have separate

sources of income.

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Medical Examination Report

Medical History and personal particulars of Students joining at IIT Tirupati

1. Full Name (in capitals) …………………………………………………..………………………

2. JEE (Adv) 2019 Roll No. …………………………… IITT Roll No.……..…………………

3. Name of Parent/Guardian ………………………………………………………………………..

4. Personal : Veg. / Non-Veg.

Abuse of substances (if any) : Smoking / Alcohol / Drugs / Any other

5. Past Medical/Surgical Treatment : No Yes

5.1 Allergies/Bronchial Asthma/Tuberculosis

5.2 Abdomen including Urinary Tract

5.3 Locomotor system (Spinal/Vertebral column/Joints)

5.4 Cardiovascular system

5.5 Neurological disorders/Psychological disorders

5.6 Sexually-transmitted/Venereal Diseases/Skin

5.7 Hepatitis

5.8 Diabetes

5.9 Rheumatism

5.10 Thyroid disease

6. Family history of any major illness : No Yes

6.1 Tuberculosis

6.2 Leprosy

6.3 Diabetes

6.4 Hypertension

6.5 Ischemic heart diseases

6.6 Psychiatric illness

6.7 Cancer

7. Identification marks : 1)

2)

8. Blood Group :

I declare that all the statements above are true and correct to the best of my knowledge. I fully understand that I am responsible for the accuracy of all statements given.

Candidate’s Signature : ………………………………………………………………………….

Counter signed by Parent/Guardian………………………………………………………………….

Date :

Place : P.T.O. (2)

CONFIDENTIAL Annexure V

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: 2 :

HEALTH CERTFICATE

1. Examination by a General Physician (M.D. in General Medicine)

I, Dr. ……………………………………………………………………………………………………

after examining (with necessary investigations) Mr./Ms. ……………………………………………

Son / Daughter of Mr./Ms. ……………………………………………………………………………….

born on …………………………

CERTIFY:

Weight ………. Kg. Height ………. cm. Blood Pressure ………….. /…………. mm Hg.

Girth of Chest : (a) At rest ……………………. : (b) After deep inspiration ………………………..

Cardiovascular System : Heart ………………… Heart Sounds ……………

Respiratory System :

Neurological System :

Psychological disturbance : Yes / No If yes, specify ………………………………….

Past Medical or Surgical Record :

Identified allergies :

Current treatments :

Current vaccination Status (All candidates who do not have adequate active/passive immunity against diseases mentioned below should take these injections/adult booster dose as recommended, just before joining the Institute and the date to be mentioned below):

VACCINATION AGAINST DISEASES

1st Injection Last Booster Date Yes / No Date Yes / No

BCG

Diphtheria – Tetanus - Poliomyelitis

Measles, Mumps, Rubella

Hepatitis B

Hepatitis A

Meningitis

Typhoid

Chicken Pox

Influenza Vaccine (H1N1)

Candidate’s Signature : …………………………………………………………….

P.T.O. (3)

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: 3 : INVESTIGATIONS

Date ……………………….. Result ………………………

Date ……………………….. Result ………………………

Date ……………………….. Result ………………………

Date ………………………. Result ………………………

1. Electrocardiogram

2. Chest X-ray

3. Sonography (whole abdomen)

4. Urine

5. Blood Tests Date ……………………….. Result ………………………

a) Blood Sugar (F/PP) Date ……………………….. Result ………………………

b) Urea/Creatinine Date ……………………….. Result ………………………

c) Peripheral Smear Study/HB% Date ……………………….. Result ………………………

d) Lipid Profile Date ……………………….. Result ………………………

e) Blood Group/typing (if not known) Date ……………………….. Result ………………………

f) HBS Ag Date ……………………….. Result ………………………

g) HIV – I & II Date …………………….. Result ………………………

Remarks / Special Recommendation, if any:

Conclusion : 1. Fit / Unfit to pursue higher education with a very tight academic schedule. 2. Does not suffer from any seizure disorder and he/she is fit for swimming

Reason :

Date :

Place : Signature & Seal

Candidate’s Signature : …………………………………………………………………………….

P.T.O. (4)

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: 4 : 2. Examination by Ophthalmologist

Acuity of Vision

Far Vision Near Vision Colour Vision Naked Eye With Glasses Naked Eye With Glasses

R.E.

L.E.

Remarks / Special Recommendation, if any :

I, Dr. …….…………………………………………………………………………………………….. have examined (with necessary investigations) Mr./Ms. …………………………………………… Son / Daughter of Mr./Ms. ……..……………………………………………………….…………. born on ……………………………… and the above information given to the best of my knowledge are correct and true.

Date :

Place : Signature & Seal

3. Examination by ENT Specialist

Inspection / hearing AudiometryRight Ear

Left Ear

Remarks / Special Recommendations, if any.

I, Dr. …….……………………………………………………………………………………….. have examined (with necessary investigations) Mr./Ms. ………………...………………………………… Son / Daughter of Mr./Ms. ……..…………………………………………………..…….…………….

born on ……………………………… and the above information given to the best of my knowledge are correct and true.

Date :

Place : Signature & Seal

Candidate’s Signature : ………………………………………………………………………

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATISOLEMN AFFIRMATION OF CONFORMANCE TO RULES AND REGULATIONS

(to be submitted by all Students / Scholars of IIT Tirupati) (TO BE FILLED ALL IN CAPITAL LETTERS)

I, Mr./Ms………………………………………………………………………………………………,

assigned with IIT Tirupati Roll No…………………………………….., am the son/daughter/ward of

Mr./Ms. ……………….………………….……………………………………………………………,

Residing at Door No. ………………………………House No……..……..……………….………….,

Street Name: . ……………………………………………………....……………………...……………,

Local Area Name: . ………………………………………………………………..……………………,

Village/Town/City Name: .……………………………………………………………………….……..,

State: . ……………………………………………………… . Pin code:………………………..……,

am joining as a student of …………………… Programme in Department of ……………….………..,

………………………………………………………

I hereby declare that, I: a) have read and understood the prevailing rules of regulations of the Instituteb) am aware of

(i) The national laws pertaining to ragging,(ii) The serious consequences of this impermissible behavior, and(iii) The administrative, legal and penal actions that will be imposed on persons apprehended,

tried and convicted of this crime; and c) am aware of the ban on the possession and/or use of alcohol or tobacco in any form and any

powered vehicles by students inside the IIT Tirupati Campus.

Keeping the above in mind, I SOLEMNLY AFFIRM that:

a) I SHALL NOT violate the prevailing rules and regulations of IIT Tirupati, my INSTITUTE;

b) I SHALL NOT indulge in ragging, nor will encourage, abet, or be indifferent towards others engagingin ragging; and, on the contrary, will work to ensure the dignity, honour and self-esteem of allstudents;

c) I SHALL NOT possess and/or use any alcohol or tobacco product and powered vehicle inside theIIT Tirupati campus, except with the due permission, if applicable, and that

I understand that if I am found violating or to have violated any of the rules and regulations pertaining to students of IIT Tirupati, I am liable to obey the rulings of the respective official authorities or Committees of IIT Tirupati and/or pay the penalty specified by them.

Signature of Student Counter Signed by Parent/Guardian

Place: TirupatiDate:

Please visit https://iittp.ac.in/pdfs/btech/B.Tech-Ordinance-Regulations-2018.pdf

Annexure VI

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SELF DECLARATION BY THE STUDENT

1) I, ________________________________________________________

_______________________________________________ (Full name of student in CAPITAL letters with

roll number) S/o D/o Shri./ Smt. ___________________________________________

___________________________________________________________ having been admitted to IndianInstitute of Technology Tirupati, have:

(a) Been advised to read carefully and understand the Supreme Court Judgement on Ragging hosted

(b)

(c)

in http://iittp.ac.in/anti-ragging/ Received a copy of the Essential Extracts of relevant Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the relevant Regulation) Carefully read and fully understood the provisions contained therein.

2) I have, in particular, understood Clause 3 of the relevant Regulations and am aware as to what constitutes raggingand the implications thereof.

3) I have also, in particular, understood Clause 7 and Clause 9.1 of the relevant Regulations and am fully aware ofthe penal and administrative actions that are liable to be taken against me in case I am found guilty of or abettingragging, actively or passively, or being part of a conspiracy to promote ragging.

4) I hereby solemnly state and undertake that:

a) I will not indulge in any behavior or act that may be considered as ragging under Clause 3 of therelevant Regulations.

b) I will not participate in or abet or propagate through any act of commission or omission that may beconsidered as ragging under Clause 3 of the relevant Regulations.

5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to Clause 9.1 of the relevantRegulations, without prejudice to any other criminal action that may be taken against me under any penal law orany 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 onaccount of being found guilty of abetting or being part of a conspiracy to promote ragging and further affirm that,in case this declaration is found to be untrue, I am aware that my admission is liable to be cancelled.

Place:

Date:

Signature of Student

Name: Telephone/Mobile No:

Address:SELF-DECLARATION

Verified that the contents of this self declaration are true to the best of my knowledge and no part of the declaration is false and nothing has been concealed or misstated therein.Place: Date: Signature of Student

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SELF DECLARATION BY PARENTS/GUARDIANS

1) I, Mr./Mrs./Ms. _______________________

_________________ (Titles, Full name of Parents/Guardians in CAPITAL letters)

Father / Mother / Guardian of Mr. / Ms. ___________________________________________________

________________________________________________ (Full name of student in CAPITAL letters

with Roll number) who has been admitted to Indian Institute of Technology Tirupati have:

(a)

(b)

(c)

Been advised to read carefully and understand the Supreme Court Judgement on Ragging hosted in http://iittp.ac.in/anti-ragging/ Received a copy of the Essential Extracts of relevant Regulations on curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the relevant Regulations) Carefully read and fully understood the provisions contained there-in.

2) I have, in particular, understood Clause 3 of the relevant Regulations and am aware as to what constitutesragging and the implications thereof.

3) I have also, in particular, understood Clause 7 and Clause 9.1 of the relevant Regulations and am fullyaware of the penal and administrative actions that are liable to be taken against my ward in case he/she isfound guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.

4) I hereby solemnly state and undertake that:

a) My ward will not indulge in any behavior or act that may be considered as ragging under Clause 3of the relevant Regulations.

b) My ward will not participate in or abet or propagate through any act of commission or omissionthat may be considered as ragging under Clause 3 of the relevant Regulations.

5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to Clause 9.1 ofthe relevant Regulations, without prejudice to any other criminal action that may be taken against my wardunder 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 thecountry on account of being found guilty of, abetting or being part of a conspiracy to promote ragging, andfurther affirm that, in case this declaration is found to be untrue, my ward’s admission is liable to becancelled.

Signature of Father/Mother/Guardian

Name:

Telephone / Mobile No.Address:

SELF DECLARATION by PARENTS/GUARDIAN

Verified that the contents of this self declaration are true to the best of my knowledge and no part of the self declaration is false and nothing has been concealed or misstated therein.

Place: Date:

Signature of Father/Mother/Guardian

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To

The Registrar

IIT Tirupati

Sir,

Sub: Application for Remission of Fee

(For those students whose parental income is less than Rs. 5 (Five) lakhs per annum)

This is to inform you that my family income from all source is Rs. ______________ / (in words Rupees

_____________________________________________) for the financial year 2018-19. In support of my claim Form-A along with a copy of IT Return for the assement year 2018-19 is enclosed.

OR

I am not required to file IT return in accordance with Income Tax Act 1961, therefore I am enclosing

Income certificate in Form - B issued in the last six months by the Revenue Officer.

---------------------------------------------------------------------------------------------------------------------------

(strike out which is not applicable)

I further declare that the above information is true to the best of my knowledge and belief and I am

aware that I am solely responsible for the correctness and accuracy of the above declaration and

understand that providing false information amounts to miscounduct and may lead to cancellation of

admission at IIT Tirupati. I further authorize IIT Tirupati to verify my income.

Accordingly, I request you to kindly exempt me from paying tuition Fee as indicated below.

(1) Rs. 1,00,000/- (Family Income less than Rs. 1,00,000/- per annum.)

(2) Rs. 66,666/- (Family Income less between Rs. 1,00,000/- and Rs. 5,00,000/-)

---------------------------------------------------------------------------------------------------------------------------

(strike out which is not applicable)

Student’s Signature : ___________________ Parent’s Signature : ___________________

Name : ___________________ Name : ___________________

Roll No. : ___________________ Address : ___________________

Department : ___________________ : ___________________

Address : ___________________ PAN : ___________________

: ___________________ UID : ___________________

PAN : ___________________ Bank A/C No : ___________________

UID : ___________________ Date : ___________________

Bank A/C No : ___________________ Place : ___________________

Date : ___________________

Place : ___________________

Annexure VII

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INDIAN INSTITUTE OF TECHNOLOGY TIRUPATI

Renigunta Road, Tirupati – 517 506

Students’ Datasheet

A. PERSONAL INFORMATION:

JEE (Adv) Registration No: All India Rank:

1. Full Name (in Block letters as per

JEE Allotment letter) (All Certificates, Grade Cards &

Transcript will be issued in this name

only)

2.Date of Birth (DD/MM/YYY) 3. Gender (M/F) 4. Blood Group 5. Height (Cm)

6. Weight (Kg) 7. Nationality 8. Category(Gen/OBC/SC/ST/PwD)

9. BPL Category (If yes, supporting documents) 10. Religion

11. State of Domicile 12. Mother Tongue

13. ID Marks 14. Presently reside at (Hostel address to be filled after admission)

15. Bank details: a. Name of Bank b. Branch c. A/c No d. IFSC

16. Mobile No: 17. Passport No: 18. E-mail Id:

19. Aadhaar No (photocopy to be attached):

20. EDUCATIONAL INFORMATION:

Examination Passed

(All Preceding Examinations)

Medium of

Instruction

Board / University

/ Institute

Year of

passing Discipline

Division/

Class

% of Marks /

CGPA

HSC (10 Level) or Equivalent

H.S. (10+2 Level) or Equivalent

Department: Roll No:

(Please fill this at the time of admission)

Date of Joining:

(Affix recent passport

size photo here)

Annexure VIII

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B. PARENTAL INFORMATION:

21. Father’s Name

(full name in block letters)

Phone No.(with STD code) Mob e-mail id

22. Mother’s Name

(full name in block letters)

23. Guardian (full name in block letters)

Father Mother Guardian

24. Occupation

25. Income (Income Certificate to be

attached)

C. RESIDENTIAL INFORMAION:

26. Present Address for Communication 27. Permanent Address

State: Pin: State: Pin:

I do hereby declare that the information furnished by me is true to best of my knowledge, belief & based on records

Signature of the Student :

Date :

Name of Parent/Guardian :

Signature of the Parent/Guardian :

Date :

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