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Transmission Record

(To be filled in by Appraisee )
Financial Year……………………. (for the period from……………… to ……………..)
Name & Designation of the Officer Reported Upon……………………………………..
.……………………………………
Service and ro!p ("#$) to %hich the Officer &elongs………………………………….
……………………………………
Details of Transmission / Movement of PAR
(To be filled in at the time of transmission
by respective officer/staff)
'ransmission
&(
'ransmitted to %hom
(Name) Designation &
"ddress)
*etter No & Date of
'ransmission
Signat!re of
Officer#Staff
'ransmitting the +"R
"ppraisee
Reporting
"!thorit(
Revie%ing
"!thorit(
"ccepting
"!thorit(
Performance Appraisal Report (PAR) for Group ‘A ! ‘" officers of Govt# of $rissa
P%R&$RMA'(% APPRA)*A+ R%P$RT
for
ro!p ,"- & ro!p ,$- Officers of ovt. of Orissa.

Report for the financial (ear...............
( +eriod from ............ to ............. )


P%R*$'A+ DATA
(To be filled in by the Appraisee )
/.F!ll Name of the Officer0
1. Date of $irth0
2. Service to %hich the Officer &elongs0
3. ro!p to %hich the Officer &elongs(" or $)0
4. Designation d!ring the period of Report0
5. Office to %hich posted %ith 6ead 7!arters0
8. +eriod(s) of a&sence (on leave) training etc.)
if 29 da(s or more). +lease mention date(s). 0
:. Name & Designation of the Reporting "!thorit( ...............................
and period %or;ed !nder him#her 0
...............................
From to
<. Name & Designation of the Revie%ing "!thorit( ...............................
and period %or;ed !nder him# her 0
...............................
From to
/9. Name & Designation of the "ccepting "!thorit( ...............................
and period %or;ed !nder him#her 0
...............................
From to
Signat!re of the "ppraisee
PART,)
PART,)) *%+&,APPRA)*A+
(To be filled in by the Appraisee )
/. $rief description of d!ties#tas;s entr!sted.(in a&o!t /99 %ords)
1. +h(sical#Financial 'argets & "chievements
S=.No 'as; 'arget "chievement > of "chievement
2. Significant %or;) if an() done
+lace ..................... Date............. Signat!re of "ppraisee
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PART,))) R%MAR-* $& T.% R%P$RT)'G A/T.$R)T0
/. (a) 'ame of the $fficer Reported /pon1
(&) Period of report 1 &rom ....#....#.......... to ....#....#...........
1# Assessment of 2or3 output4 attributes ! functional competencies. ('his sho!ld &e on a relative scale
of /?4) %ith / referring to the lo%est level & 4 to the highest level. +lease indicate (o!r rating for the officer against
each item#)
Description Ratin5 Description Ratin5
(a) "ttit!de to %or; 0 (f) @o?ordination a&ilit(0
(&) Sense of responsi&ilit(0 (g) "&ilit( to %or; in a team.
(c ) @omm!nication s;ill 0 (h) Ano%ledge of R!les#+roced!res# ='
S;ills# Relevant S!&Bect 0
(d) *eadership 7!alities 0 (i) =nitiative 0
(e) Decision?ma;ing a&ilit( 0 (B) 7!alit( of Cor; 0
2. eneral "ssessment (+lease give an overall assessment of the officer incl!ding his#her attit!de to%ards
S.'#S.@#Cea;er Sections & relation %ith p!&lic)0
3. =nadeD!acies) deficiencies or shortcomings) if an( (Remar;s to &e treated as adverse )
4. =ntegrit( (=f integrit( is do!&tf!l or adverse please %rite ENot certifiedF in the space &elo% and B!stif( (o!r remar;s in
&oG 3 a&ove)
38. 5. Overall rading (Please sign in appropriate box)

O!tstanding Her( ood ood "verage $elo% "verageI
(rade?4) (rade?3) (rade?2) (rade?1) (rade?/)
For Overall rading E"elo2 Avera5eF # E$utstandin56 please provide B!stification in the space &elo%.
Name of Reporting "!thorit(0 Signat!re
Designation d!ring the period !nder report0
Designation at the time of recording of remar;s0
+lace 0 Date ? ?
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PART,)7 R%MAR-* $& T.% R%7)%8)'G A/T.$R)T0
'ame of the $fficer Reported /pon1
Period of report 1 &rom ....#....#.......... to ....#....#..........

/. +lease =ndicate if (o! agree %ith the general assessment# adverse remar;s# overall grading made &( the
Reporting "!thorit() and give (o!r assessment.
1. Overall rading (Please sign in appropriate box)
O!tstanding Her( ood ood "verage $elo% "verageI
(rade?4) (rade?3) (rade?2) (rade?1) ( rade?/)
Name of Revie%ing "!thorit( Signat!re
Designation d!ring the period !nder report0
Designation at the time of recording of remar;s0
+lace0 Date0 ? ?
PART,7 R%MAR-* $& T.% A((%PT)'G A/T.$R)T0
Period of report 1 &rom ....#....#.......... to ....#....#...........
Name of "ccepting "!thorit( 0 Signat!re
Designation d!ring the period !nder report0
Designation at the time of recording of remar;s0
+lace 0 Date0 ? ?
&$R $&&)(% /*% "0 T.% PAR "RA'(.
JFor revie% as %ell as other certificates#remar;sK
I E$elo% "verageF grading %ill &e treated as adverse and sho!ld &e B!stified) if Reporting "!thorit( has not alread(
B!stified
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