Page 1 of 7

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)

PART - 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 ..

EDUCATIONAL AND OTHER QUALIFICATIONS

1.

2.

3.

EXPERIENCE

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.

Page 2 of 7

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

Page 3 of 7

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.

3

Page 4 of 7

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.

4

Page 5 of 7

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

5

Page 6 of 7

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

Page 7 of 7

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 prevai l.

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.

7