Indian institute of technology, bombay

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FORM NO: 1

INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

Dissertation/ Project Report Submission Form ( Four Copies)

And Information Card for Degree Certificate

M.Tech./ D.I.I.T./ M.Des./M.Phil.
NOTE: THE INFORMATION ON THIS CARD WILL USED FOR THE PREPARING YOUR

DEGREE CERTIFICATE. PLEASE PRINT FOR OR WRITE CLEARLY.

Name: ____________________________________________ Sex: Male/Female

Roll No: ______________________ Batch:_________________

Programme : _____________________________________________________________

Department: ______________________________________________________________

Hostel No: _______________________________ Room No: _______________________

Specialization: ____________________________________________________________

Project Report Title ( Use Block Letters, write in English only ) : _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

Name of the Supervisor: ____________________________________________________

Name of the Co-supervisor: _________________________________________________

Examination Fee: __________________________________________________________

Receipt No: ______________________ Date: _________________________

Enclosed Clearance Certificate:

Account Section: Yes/No II. Students Account Unit: Yes/No

Date of Submission :________________________________________________________

Address for Communication :

(Where degree certificate may be issued after convocation, if necessary ) in English
__________________________________________________________________________Project_Report_received_in_Department_Office__Receivers_Name__Signature_Date:_Note'>___________________________________________________________________________________________________________________________________________________________________________________________________________________________

Certified that all the copies of Project Report/ Dissertation strictly in accordance with the prescribed format.

Signature of the Student Date:

_________________________________________________________________________
Remarks: Recommendations of the Supervisor (s) authorizing the Department office to receive four copies of the Dissertation/ Project Work.

Signature of the Supervisor (s) Date:

_________________________________________________________________________
Project Report received in Department Office

Receivers Name & Signature Date:

Note: Department Office should arrange to send one copy of the submission report form to Academic Office soon after submission.

Date of Receipt in Academic Office:

Receivers Signature & Date:

FORM NO: 2

INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

Department of Mechanical Engineering
PROFORMA FOR PANEL OF EXAMINERS AND DETAILS OF FINAL EXAMINATION OF PROJECT
Name of Student: _________________________________________________________
Roll No: __________________________________________
Academic Programme: M. Tech / Dual Degree (Please encircle correct alternation )
Department/School/DP Group/Centre: _________________________________________
Specialization: ____________________________________________________________
Date of Examination: __________________________ Time: _____________________
Venue of Examination: ______________________________________________________
Title of Dissertation: ________________________________________________________

Name & Address of External Examiners: ________________________________________

_________________________________________________________________________
_________________________________________________________________________
Chairperson: _______________________Department of __________________________

External Examiner: __________________Department of___________________________

Internal Examiner: __________________Department of___________________________
Second Internal Examiner if approved by DPGC in absence of External

Examiner: _________________________Department of___________________________

Guide: ___________________________Department of____________________________

Co-Guide: _________________________Department of___________________________

Signature of Guide: __________________

Signature of Convener, Postgraduate Committee (PGC):_____________________________

Head of the Department: _________________________

FORM NO: 3
INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY
FINAL SUBMISSION OF DISSERTATION/ THESIS REPORT

(AFTER DEFENCE/ VIVA-VOCE EXAMINATION)
Part I

FOR MASTER’S PROGRAMME STUDENTS:

The students should submit the prescribed form from submission of dissertation/Reports to the academic units/academic office, duly signed by the concerned Academic Committees, within 30 days, from the successful completion of Master’s defence, failing which a fine of Rs. 5000/- per month will be levied to the concerned student.

FOR Ph.D. PROGRAMME STUDENTS:

After successful completion of the Ph.D. Viva-voce examination, the students shall submit to the Academic Office the two copies of his/her approved thesis, duly bound, together with the application for submission of the same in the prescribed format, within TWO months, from the date of defence, failing which a fine of Rs. 5000/- per month will be levied to the concerned student.

Date:___________________

To,

The Deputy Registrar (Academic)

Sir,
I am submitting electronic/ bound copy(s) of my thesis/dissertation, the title of which is: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
All the copies of the thesis/ dissertation have been prepared in accordance with the instructions issued by the Institute regarding the format.

I have incorporated additions / alterations, etc. as suggested by the external examiner/ board of examiners. A certificate to this effect from my supervisor is appended below.

I request you to issue the orders to give me the provisional certificate for having fulfilled the requirements for the award of the degree of ________________________________________.

Yours Sincerely,

___________________________

(Signature of the candidate)

Name: Mr/Ms. _________________________________________________________________
Roll No:____________________________ Programme:___________________ Batch:________
Department/ IDP: ______________________________Specialisation:_____________________

Part II

CERTIFICATE TO BE GIVEN BY THE SUPERVISOR(S)
Certified that the corrections/ alterations as suggested by the external examiner/ board of examiners have been incorporated by the student, and the two bound copies of thesis/ dissertation may be accepted.

Signature of Ph.D. Supervisor(s): ________________________ ________________________

Name(s) of Ph.D. Supervisors: (Prof. ) (Prof. )

CERTIFICATE FROM CENTRAL LIBRARY
This is to certify that the Central Library is in receipt of soft copies of both the extended abstract and the thesis/ dissertation.

___________________________

Librarian, Central Library

(Signature and Stamp)

CERTIFICATE FROM THE DEPARTMENT

(For the students of Mater’s Programme)

Certified that the above student has submitted his/her dissertation in Electronic/ Hard copy format to the Department.
___________________________

Office Superintendent

(Signature and Stamp)

Date: ________________

CERTIFICATE FROM THE ACADEMIC SECTION

(For the students of Ph.D. Programme)

Certified that the above student has submitted two bound copies of the Thesis to the Academic Section.
_______________________________________________

Office Superintendent/Dealing Assistant (Academic)

(Signature and Stamp)
Date: ______________

Part- III
NO DUES CERTIFICATES

Certificate from Librarian

This is to certify that there are NO DUES/ DUES : _____________________________

In r/o. Mr. /Ms. _______________________________ Roll No. _________________

M.Tech /M.Mgt /M.Des. /M.Phil /Ph.D. Student.

_____________________________

Librarian, Central Library

Date: (Signature and Stamp)

Certificate from Department/Centre/School/IDPs

(Online Submission)
This is to certify that there are NO DUES/ DUES : _____________________________

In r/o. Mr. /Ms. _______________________________ Roll No. _________________

M.Tech /M.Mgt /M.Des. /M.Phil /Ph.D. Student.

__________________________________

Head/Convener, Dept/Centre/School/IDPs

(Signature & Stamp)

Date: ______________

Certificate from Hostel/ Hostel Co-ordinating Unit

This is to certify that there are NO DUES/ DUES : _____________________________

In r/o. Mr. /Ms. _______________________________ Roll No. _________________

M.Tech /M.Mgt /M.Des. /M.Phil /Ph.D. Student, who is/was residing in Hostel no.______________.

_________________________________

Head/ Convener, Dept/Centre/School/IDPs

Date: (Signature and Stamp)

(Only, If Applicable)

Certificate from Estate Office

This is to certify that there are NO DUES/ DUES: ______________________________

In r/o. Mr. /Ms. _______________________________ Roll No. _________________

M.Tech /M.Mgt /M.Des. /M.Phil /Ph.D. Student, who is/was residing in __________

_____________________________.

Certificate from Akash Logistics Distribution Centre

This is to certify that Mr. /Ms. __________________________________________ Roll No._________________ enrolled in ________________programme in the Department of __________________________ has returned the Akash Tablet issued to him/her for the academic purpose/paid fine of Rs. 2263/- being the price of the Akash Tablet issued to him/her for academic purpose which he/she has lost/damaged, to the Aakash logistics distribution centre on______________ .

There are No Dues to be recovered from him/her.
______________________

Authorized Signature

Operations Lab, NMEICT

(STAMP)
Date:

Form No: 4

INDIAN INSTITUTE OF TECHNOLOGY BOMBAY

DEPARTMENT OF MECHANICAL ENGINEERING
DATE:______________________
All the Incharge/Labs/Sections are requested to kindly intimate if there are any dues outstanding against the following student/personnel who has relieved from the institute on: _____________________________.
Roll No:_______________________ Name:________________________________
Programme:____________________________Section:________________________

SR.NO	NAME OF LAB/SECTION	REMARKS	SIGNATURE WITH DATE
1	Computation Lab
2	Comp. Aided Manufacturing
3	Computer Graphics
4	Department Library
5	Department Stores
6	Drawing Office
7	Fluid Power
8	Fracture Mechanics
9	Heat Transfer & Thermo
10	I .C. Engines
11	Instrumentation
12	Machine Design
13	Machine Tool Lab
14	Metal Forming & Casting
15	Nuclear Engineering
16	Refrigeration
17	Robotics
18	Steam Power
19	Strength of Materials
20	Workshop
21	Suman Mashruwala Lab
22	THTF Lab
23	Care Lab
24	Mechatronics
25	Tribology

Form No: 5

INDIAN INSTITUTE OF TECHNOLOGY BOMBAY

DEPARTMENT OF MECHANICAL ENGINEERING
Payment of Honorarium and Conveyance charges to External Examiner for attending M.Tech. Viva-voce Examination.

______________________________________________________________________________

Name of External Examiner: _______________________________________________________
Address of External Examiner: _____________________________________________________

_____________________________________________________

Particulars of Viva Voce Exam: Date: Time:

Particulars of Student(s):
Name: _______________________________________ Roll No: _________________________

Name: _______________________________________ Roll No: _________________________

Amount Incurred for Conveyance Rs.________________________________________________
Signature of the Examiner

Chairman

Board of Examiners

RECEIPT
Received from the Head. Dept. Of Mechanical Engg. IIT Bombay a sum of Rs.____________ (Rupees) towards Honorarium and conveyance charges for attending viva voce examination of

M.Tech student(s) as shown above.

Date: Signature:

Name:

Sanctioned honorarium Rs_________________ and Conveyance charges as given above.
Honorarium:

Conveyance:

Total :

Head

Department of Mechanical Engineering

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