Date: 13-14 July 2012 Venue: J.N.

Tata Auditorium, IISc, Bangalore

Abstract / Full Paper Declaration Form

This Declaration Form must be signed by the author/all the authors (in case of joint authorship). In absence of the duly filled-in Declaration Form paper will not be taken up for Proceedings.
Name of Principal Author (IN BLOCK LETTERS) Address (Office)

E-mai*l

Mobile*

Name of Co-Author -1 (IN BLOCK LETTERS) Address (Office)

E-mail*

Mobile*

Name of Co-Author - 2 (IN BLOCK LETTERS) Address (Office)

E-mail*

Mobile*

PAPER ENTITLED _________________________________________________________________________________________ _______________________________________________________________________________________________________

1. I/We certify that my/our above mentioned paper, now submitted to Indian Technology Congress 2012 (ITC 2012) for publication in its Conference Proceedings, has neither been submitted for publication nor so far published in any Conference/Journal or Magazine. I/We further undertake that the paper now submitted is not copied or plagiarized version of some other published work. 2. I/We declare that I/we shall not submit the paper for publication in any other Conference/Journal or Magazine till the decision of the ITC 2012 is made known to me/us. 3. If the paper is finally selected by the ITC 2012 for printing in Special Issue of MT&M Journal, I/we agree not to send the paper for publication in any other Journal or Magazine. 4. If the paper is to be reprinted in any other Journal or Magazine subsequently, the permission of the ITC 2012 will be duly taken well in advance. 5. I/We understand that submission of false or incorrect information/undertaking would invite appropriate penal actions of the Conference. Legal action will be taken also as per IPC.
Signature: Date

Main Author Co-Author (1) Co-Author (2) *These fields are mandatory Any change in the mailing address after submission of this Declaration Form, should promptly be intimated to the ITC 2012.