Fillable Printable Employee Self Evaluation Form Template
Fillable Printable Employee Self Evaluation Form Template
Employee Self Evaluation Form Template
PERFORMANCE APPRAISAL FORM II (B)
For Senior Superintendents / Managers/ Administrative Assistants / Officers/ Accounts Officers /
Financial Assistants/ Officers and Junior Executive Officers / Senior
Executive Officers (Non - Secretariat Service)
P
ART
- I
APPRAISAL OF
Department: Shri / Smt…………………………………………………………………….. (in block letters)
for the period of………………………………………………………………………………
Name ..
Date of birth ..
Post ..
Date of entry in Government Service ..
Date of appointment to the present post ..
Date of entry in the present Department / Office ..
Pay and Scale of pay ..
Date from which functioning in the present
grade continuously ..
List of subjects dealt with according to the
office order d istributing work ..
E
DUCATIONAL AND
O
THER
Q
UALIFICATIONS
1.
2.
3.
E
XPERIENCE
Department Category of work
Period
From To
Category of work may be any of the following items: Establishment, Accounts & Budgetting, Cash, Stores, Records, Planning,
Office Section and Miscellaneous and in the case of Executive Officer the nature of field work.
SELF ASSESSMENT
(To be obtained from the reportee in a separate sheet and filed as part of the facing sheet of the form)
Instructions to Reporting Officers
1. Consider only one factor at a time
2. Study each factor and the specification for each grade
3. Review upon completion to see that the rating of each factor applies exclusively to the individual's actual performance on his present
job.
4. Comment fully at the bottom of the page and on reverse side upon any matter which in your opinion needs explanation.
5. Put a tick ( S) mark in the appropriate boxes provided hereunder-
Section A
ASSESSMENT BY THE REPORTING OFFICER
SI.
No.
Factors A B C D
1.
Intelligence
Extraordinarily proficient
and resourceful and
understands new and
difficult matters
Quite able to
handle new and
difficult matters
Normally under- stands a
new situation after proper
explanations and
handles it if given all
directions
Poor comprehension
as usually. Fails to
perform a function
despite prior
instructions
2.
Initiative and Resource-
fulness
Resourceful & original in
giving suggestions and
pursues them
constructively
Shows reasonable
degree of initiative and
resourcefulness
Tends to wait for
direction
Cannot perform
without close
supervision and
guidance. Limited
desire to achieve
task
3.
Discipline
Exceptionally punctual
in all matters and
exemplary conduct
Always punctual,
observes the code of
conduct
Usually punctual, tries
to follow the general
code of conduct
Not punctual,
indifferent to general
code of conduct.
Shriks responsibility
4.
Responsibility and
Dependability
Sincerity of responsibility
and Conscientiousness
towards duty
Very conscientious and
dependable in the
performance of his / her
job. Always ready to take
responsibility
A steady worker with a
good record of
dependability
Reasonably
conscientiousness and
does his / her job in a
routine manner
Often fails to perform
his/ her duty
5.
Co-operation and
Personal relations
Co-operation with
superious and colleagues
and personal relations with
public where relevant
Extremely Cooperative,
maintains outstanding
good relations, alround
earning respect from
his / her colleagues
Always Cooperative and
generally maintains with
effort reasonably good
relations
Co-operative maintains
with effort reasonably
good relations
Does not get along
well
2
No. Factors A B c D
6. Interest In the
Assignment
Takes keen interest
Takes adequate interest
Does his / her work in a
routine way
Indifferent in the
discharge of his / her
duties
7. Job Knowledge
Technical and general
knowledge about the job.
he/she is doing
(a) General (of this and
related subjects or
versatility)
(b) Of work
(c) Up - to - darkness
Has an unusually thorough
and comprehensive
mastery of his / her field of
work. Strives to expand his
/ her frontier of knowledge
Knows his / her job
thoroughly
Possesses just adequate
knowledge required of
the job
Knowledge
inadequate. Has not
yet gained
competence
8. Noting, Drafting and
Correspondence
Ability to prepare notes,
drafts and handle
correspondence with
special reference to -
(1) Accuracy
(2) Thoroughness
(3) Power of analysis
(4) Power of expression
Very percise in nothing &
drafting. Very prompt and
accurate at corre-
spondence. His / her drafts
need no editing
Precise in nothing and
drafting. Good at
correspondence.
His / her drafts seldom
require editing
Ordinary at nothing and
drafting. His / her drafts
need editing. Tries to
handle correspondence
in time if property
supervised
Poor in nothing and
drafting. Careless in
handling
correspondence
9. Leadership and Drive Possesses excellent
qualities of leadership and
drive
Possesses good
qualities of leadership
and drive
Has qualities of
leadership and drive
Poor to leadership
and drive
10. Power of Analysis
Judgment
Capacity to analyse
problems and ability to
arrive at sound
conclusions
Gets systematically to the
root of the problems and his
/ her judgment is
consistently sound and
comprehensive
Almost invariably
analysis the problems
thoroughly. His / her view
is nearly always sound
and comprehensive
Usually analyses the
problems adequately and
generally takes a sound
view
Often misses the
essential point
Judgement often
not sound
11.
Supervision and Control
Ability to supervise and
control. Skill in maintaining
the morate of his /her
staff. Capacity to train,
help advise and handle
subordinates
Successful, efficient and
capable supervisor. Runs
his / her organisation
smoothly and effectively.
Very capable and
successful to train, help
advise and to handle his /
her subordinates
Good Supervisor.
Runs his / her
organisation reasonably
well. Capable to train
help, advise and to
handle his / her
subordinates
Moderate ability to
supervise and run the
organisation. Ordinary to
train, help, advise and
to handle his / her
subordinates
Lacks control over
staff and leaves
things to his / her
subordinates.
Capacity to train,
help, advise and to
handle subordinate,
inadequate.
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SI.
No.
Factors A B C D
12. Quality and Quantity
of Work
Quantum of work to be
done, quantum actually
done and the promptness
with which it is done
Distinguished output of
work both in quantity
and quality
Turns out more than
adequate volume of work
of good quality
Adequate output and
quality
Output and quality
regularly insufficient
13. Ability to communicate
and Receptiveness to
ideas of others
Exceptionally skilled in
conveying ideas in clear,
logical and convincing
manner.
Extremely receptive to
ideas of others
Able to convey ideas in
clear logical and
convincing manner.
Receptive to ideas of
others
Moderate ability to
convey ideas and
moderately receptive to
others' ideas
Lacks ability to
convey ideas in clear,
logical and
convincing manner.
Not receptive to
others' ideas.
14. Use of delegated powers Always uses delegated
powers and takes
responsibilities
Generally uses
delegated powers
Has to be told to use his /
her delegate powers
Fails to use
delegated powers
even after being
instructed
15. Attitudes / achievements
in the implementation of
programmes
Schemes of SCs/STs and
prevention of actrocities
on them
Extremely alert in I tackling
the problems of
downtrodden
Always takes keen
interest in solving the
problems of SC / ST
Usually analyses the
problems and finds a
solution
Fails to solve the
problems of SC
16. Punishments Awarded to the Officer if any
(Attach copies of the orders or punishment also)
* This will apply only to those employees who deal with the protection of and implementation of welfare and development schemes of
SCs./STs.
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GENERAL
1. Do you know of any physical disability of health problem which
prevent this Officer from working to full capacity? Yes ( ) No ( )
If yes, please explain the nature of this problem
2. General grading :
(5) No. of items in Grade A
(6) No. of items in Grade B
(7) No. of items in Grade C
(8) No. of items in Grade D
Comment with special reference to :
1. The adverse remarks passed against the employee within the
course of his / her performance or the disciplinary action
taken against him / her during the period under report.
2. The efforts made to improve the functioning of the employee
where his / her performance with reference to the factors
enumerated in this report is considered not up to the mark of
poor.
6. The important requirements or factors which affect the effec-
tiveness of the work of the Officer such as special difficulties
or handicaps, amount of direct or indirect supervision, the
emergency demands, if any, etc., and
7. Specific instances of any work worth of being mentioned in
support of the assessment in the graphic section. (Add
separate sheets if necessary)
Signature of Reporting Officer
Name:
Date of submission to Reviewing Officer Designation:
Section B
REMARKS OF THE REVIEWING OFFICER / AUTHORITY
Signature of the
Reviewing Officer / Authority
Name:
Designation:
REMARKS OF THE NEXT HIGHER AUTHORITY
(In cases where the Head of Department is not reviewing authority)
Signature
Date: Name:
I have read the report
Date: Signature of Officer reported upon
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PART - II
SECRET
(Not to be shown to the Officer reported upon)
(This part will not be the basis for promotion in the normal course)
2.
Loyalty (so as to judge his/her suitability for assignment to sensitive posts)
Has anything come to your knowledge which reflects adversely
on the officers loyalty. Yes ( ) No ( )
If „Yes‟ please give details (Add separate sheets if necessary)
2. Integrity and General Reputation :
a). Has anything come to your knowledge either as oral or written
complaint or otherwise which reflects adversely
1) On the Officers ability to honestly execute his duties Yes ( ) No ( )
ii) Showing favouritism in discharging his duties Yes ( ) No ( )
(iii) If 'Yes' please give details of particulars Yes ( ) No ( )
b) (i) Is there been any preliminary finding regarding the corrupt
practices of the Officer
(ii) Has any case of corruption on the Officer been referred to
Vigilance Department after preliminary enquiries Yes ( ) No ( )
If 'Yes' give details
3. Whether the officer requires any training for the purpose of
his present job or for any higher responsibilities Yes ( ) No ( )
4. Whether the officer should be posted to some other section/office
for better work or for other reasons (to be specified) Yes ( ) No ( )
Date: Signature of the Reporting Officer
Name:
Designation
Date/ of submission to the Reviewing Officer
REMARKS OF THE REVIEWING OFFICER /AUTHORITY
Do you agree with the assessment made by the Reporting Officer Yes ( ) No ( )
If you wish to modify anything or add, please elaborate
Signature of the Reviewing Officer/Authority
Name
Designation
6
INSTRUCTIONS
1. Performance Appraisal Form II (A) is meant for the category of Head Clerks, Junior Superintendent etc. of Non-Secretariat Service.
2. The form will also used for the personnel belonging to the above said categories working in other Departments / Institutions on deputation,
Foreign Service conditions, etc, and for „Non-gazetted‟ Technical Officers, When this is used for Non-gazetted Technical Officers, the
designation of the officers will be typewritten at the top of the forms and against irrelevant columns, the works 'not applicable' will be
entered.
3. The form consists of two parts viz : Part I and Part II. The facing sheet of Part I will be got filled up by the reportee. A note on "Self
Assessment" should be obtained from the reportee and filed as part of the facing sheet. “Self Assessment” to the context means a brief
resume of work done by the Officer reported upon during the period under report bringing out any special achievement of his / her during
the period, to be filled by the Officer reported upon. The resume should not exceed three hundred words. The “Self Assessment” given by
the reportee will help the Reporting Officer to make the ratings. The graphic portion of Section A of Part I will be prepared by marking the
appropriate grading items against the factors given. Part I will be shown to the reportee and his signature obtained. Part II is meant for
recording the assessment of the Reporting / Reviewing Officer and his signature obtained. Part 11 is meant for recording the assessment
of the Reporting / Reviewing Officer on the loyalty rid integrity of the reportee. This part will be considered as “Secret” and should not be
shown to be reportee. This will not be a basis for determining the Officer‟s suitability for promotion / appointment to higher posts.
4. Special care should be taken in filling up the Performance Appraisal forms by the Reporting and reviewing Officer.
5. The rating should be done taking; into account the individual's actual performance on the job during the period under report.
6. The Reporting Officer should take special care to study the factors for appraisal and apply them judiciously on the reportee‟s performance.
7. The Reviewing Officer will record his remarks in a narrative form in the column provided in the form. If he finds it necessary to revise the
gradings given by the Reporting Officer he will do so, in which case the grading given by the Reviewing Authority will prevail.
8. It is the duty of the Reporting Officers / Reviewing Officers to see that no item in the form is left unfiled.
9. The Reporting Officer in respect of a person in the category of Managers / Senior Superintendents / Financial Assistants / Administrative
Assistants / Junior Executive Officers / Senior Executive Officers, etc., shall be his immediate superior under whom he is working and the
Reviewing Officer shall be the authority to which he reporting Officer is subordinate.
10. In the case of other categories of Officers like Administrative Officers / Financial Assistants / Financial Officers, Accounts Officers in
Regional Offices and Institutions, the immediate Superior Officer concerned will write up the appraisal form / confidential records and the
heads of departments shall be the Reviewing Officer.
11. In all other matters, viz disposal of representations received from the reportees, period of writing the report etc., and on matters not
covered by these instructions, the procedure laid down in G.O. (P) No. 344/PD. dated 22-8-1966 as amended from time to time will apply.
12. In the case of Joint Secretary to Government working on other duty as Administrative Officer in the State Institute of Encyclopaedic
Publications, the Secretary / Special Secretary, Higher Education will be the Reporting Officer and the Chief Minister will be Reviewing
Authority.
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