FOR OUTSOURCE EMPLOYEES

ANNUAL PERFORMANCE APPRAISAL REPORT

• This report in respect of contractual employees of State Life and outsourced employees of the
program will be initiated by respective employee and submitted to In charge within 20 days of
completion of calendar year.

• The report must be completed objectively and factually. While recommending increment it must be
ensured that the employee has performed reasonably during the service year.

• The countersigning officer may modify or expand the evaluation by the reporting office if necessary.
The assessment by countersigning officer will be final so far as the performance report of employee is
concerned.

REPORT FOR THE PERIOD FROM______________TO _______________

(to be completed by the employee)

Employee Name Employee No.

Designation Date of Joining

Place of Qualification
Posting/Deptt
Training Received Qualification
Improved
Employee Present Gross
Signature & Date Salary
and Time

Page 1 of 4
 FOR OUTSOURCE EMPLOYEES

(TO BE COMPLETED BY P&GS)

Previous Years Increase %age:

1. ________________2. _________________ 3. ________________ 4. _______________
5._______________

Present Nature of job. _________________________________

Any warning letters issued? If Yes state number and reason

__________________________________________________________________________
(Support Document Attached)

Any Disciplinary Action in during in the Current Year? If Yes, State the nature:

(Support Document Attached)

Leaves Availed During the Year Late Comings During the Year
_______________________ ____________

Reporting officers Signature Incharge P&GS Signature & Stamp

Dated: _____________________ Dated: _____________________

Page 2 of 4
 FOR OUTSOURCE EMPLOYEES

EVALUATION SCORE AND ITS CONVERSION TO %AGE INCREASE

FACTORS EVALUATED DETAIL TOTAL GIVEN

MARKS MARKS
Knowledge of Job Degree to which the employee knows and 10
understands the intricacies/ contents/
requirements of the job/s under his charge.
Participation in Training Degree to which the employee participates in 10
Session training session

For Field – Assessment Degree to which the employee demonstrates 20

Score (HFs) / PMS good performance in online assessment,
Performance (DMOs) / PMS, monitoring reports etc.
Monitoring Report
(PMOs) For office: Degree to which employee is
actively involved in delivering maximum
For office: work.
Quantity of Work

Punctuality Degree to which employee observe office 10

timing and punctuality in performance of his
services
Faithfulness in coming to work in the
morning and after lunch and confirming to
work hours and work beyond duty timings
and off-days

Honesty & Integrity Reliance that can be placed upon him for 10
disposal of work and in financial matters
Results Quality and volume of work accomplished 10
under his charge, results of the group
supervised
Initiative Degree to which employee proceed on its 10
own to perform and complete assignments

Cooperation Degree to which employee proceed on its 10

and ability to work in own to perform and complete assignments
groups
General Attitude and Interest and enthusiasm vis-a-vis indifference 10
Behavior to improve efficiency and productivity and
standards of discipline, sense of responsibility
and loyalty to the organization.
TOTAL MARKS AVAILED 100

Page 3 of 4
 FOR OUTSOURCE EMPLOYEES

Rating converted to the %age increase as per following formula (please tick the appropriate
box)

Grading Rating Over All

Rating
A Most Outstanding 90-100
B Very Good 80-89
C Good 70-79
D Average 60-69
E Below Average Below 60

Reporting officers Signature

Dated: _____________________
Adverse Remarks to be communicated to the employee:
________________________________________________________________________
________________________________________________________________________

(To be filled by Zonal Head H&AI / Regional Chief H&AI / Divisional Head H&AI)
Is employee has performed satisfactory during the reporting and eligible for increment?

Yes No

If No, how much probation time will be given to employee to improve the performance and
conduct re-assessment? (Support Document Attached)

3 Months 6 Months 9 Months 12 Months

Adverse Remarks to be communicated to the employee:

__________________________________________________________________________
Zonal Head / RC / Divisional Head H&AI
Dated: _____________________

Page 4 of 4