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Performance Appraisal Form 1
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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