EMPLOYMENT STATUS REVIEW

1. Employees' Data
Empl Name :________________________ Empl Nr.:_____________ Qualification : _____________________
Department :_____________________ Date Joined :_____________ Length of Service :__________ Years.
Position :________________________ Salary :____________ Allowance :_________

2. Completed by Superior
S/n Factor Remarks Point
1 Kualitas Kerja ( Quality of Work)

2 Kuantitas Kerja ( Quantity of Work) Aknowledged by Employee

Profesional Dalam Pekerjaan
3 ( Professional of Work)
Penguasaan Pekerjaan( Knowledge
4 of the job scope)
5 Loyalitas ( Loyality)
6 Disiplin ( Dicipline) Name, Signature
7 Penampilan ( Appearance) Date : ___________
Kemampuan Managerial
8 (Staff)Managerial Skill
Kecerdasan dalam berpikir
9 Initiative)
10 Kemandirian ( Dependability)
11 Ketahanan Fisik Dan Mental
Points given 1-11 Total ____________________ Average Rating : ______________

RATING : Below Average = 0 ; Average =1; Good = 2; Very Good = 3 Outstanding = 4

3. TO BE COMPLETED BY SUPERIOR AFTER "2" IS ACKNOWLEDGED

Basic wage from___________ to ________ %_____

Allowance from __________ to __________;

Title from ___________________ to__________;

Any other changes, please state: _________________________________________

EMPLOYEE CONCERN & FEEDBACK __________________________________________

Proposed by :
Mr/Mrs/Miss :_______________________ Department//Section :__________________________
Date : ______________________________ Signature :__________________________________

4. APPROVED BY ( Director)

Name: _______________ Signature :__________________ Date :_______________