FORM FOR PERFORMANCE REPORT OF OFFICERS OTHER THAN THOSE BELONGING TO

CIVIL SECRETARIAT AND DISTRICT LEVEL OFFICERS

Department/Office: _________________________ Report for the year/Period ending: ___________________

PART-I Personal Data

(To be filled in by the Department)
1. Name of the officer: ________________________________________________________________________
2. Date of Birth: _____________________________________________________________________________
3. Present post and date of appointment: _________________________________________________________
4. Period of absence from duty, on leave, training etc.: _______________________________________________

PART-II
(Assessment by the initiating officer)
1. General Assessment Excellent Good Satisfactory Below job requirement
i) Knowledge of work
ii) Power of acquiring
general information
iii) Attention to details
iv) Industry and conscientiousness
v) Judgement
vi) Speed of disposal
vii) Initiative
viii) Control over subordinates
ix) Relations with public
x) Integrity
xi) If the officer has done any notable
work brief mention thereof may be
made. Similarly if the officer has been
reprimanded for indifferent work thereof
should be made.

2. Any remarks (Give special comments

on officer’s aptitude for special work etc.) ______________________________________________________

Signature of initiating Officer

Dated: ________________ Designation

PART-III

3. Remarks of Reviewing Authority: ______________________________________________________________

Signature of Reviewing Authority

Dated: ________________ Designation

PART-IV

4. Remarks of Accepting Authority: ______________________________________________________________

Signature of Accepting Authority

Dated: ________________ Designation