Department of Animal Husbandry and Veterinary, Government of Mizoram, India

ANNEXURE – II

FORM OF CONFIDENTIAL REPORT OF LOWER/UPPER DIVISION CLERK

Ministry/Department/Office:

Report for the year/period ending:

Part – I – Personal Data

( To be filled by the Administrative Section concerned of the Ministry/Department/Office)

1.	Name of official	-
2.	Designation/Post held	-
3.	Date of birth	-
4.	Whether official belongs to Scheduled Caste/Scheduled Tribe	-
5.	Date of continuous appointment to the present grade, viz	-
6.	Whether permanent, temporary or officiating	-
7.	Section(s) in which served during the year/period under report and period of service in each	-
8.	Period of absence from duty / (on leave, training, etc.,) during the year/period	-

Part – II – Self Appraisal

Brief description of duties:

2. Brief resume of the work done by you during the year/ period from _______________ to ______________ bringing out any special achievements during the year/ period. In the event of shortfall in achievement furnish reasons. (The resume is to be furnished within the space provided; limited to 300 words and is required to be signed)

Signature of the Government Servant

Part – III – Assessment by the Reporting Officer

(Please read carefully the instructions given at the end of the form before filling the entries)

1.	Does the Reporting Officer agree with the statement made in Part-II; if not, the extent of disagreement and reasons thereof.	-
2.	State of health.	-
3.	General intelligence and keenness.	-
4.	Proficiency in typing (in both speed and accuracy).	-
5.	Proficiency in his work, viz., maintenance of prescribed registers and charts etc.,	-
6.	Intelligence, keenness and industry.	-
7.	Has he ever been entrusted with work other than routine? If so, indicate his capacity to express himself with clarity and comprehension, in his notes and drafts.	-
8.	Amenability to discipline.	-
9.	Punctuality in attendance.	-
10.	Relations with fellow employees / Public Relations (wherever applicable)	-
11.	Has the officer been reprimanded for indifferent work or for other causes during the period under report? If so, please give brief particulars.	-
12.	Has the officer done any outstanding or notable work meriting commendation? Briefly mention them.	-
13.	Integrity (Please see Note below the Instructions).	-
14.	Grading (Outstanding /Very Good /Good/ Average) (An Officer should not be graded outstanding, unless exceptional qualities and performance have been notices: grounds for giving such a grading should be clearly brought out. )	-
15.	Effectiveness in the development and protection of Scheduled Castes and/ or Scheduled Tribes.	-
	(a) Attitude towards SCs and/or STs.	-
	(b) Sensitivity to social justice	-
	(c) Ability to take quick and effective action to prevent and quell atrocities and ensure justice to SCs and/or STs.	-
	(d) Effectiveness in bringing about the development of SCs and/or STs.	-

Signature of the Reporting Officer

Name in Block letters:

Place: Designation:

Date: (during the period of report)

Part – IV – Remarks by Reviewing Officer

1.	Length of service under Reviewing Officer.	-
2.	Is the Reviewing Officer satisfied that the Reporting Officer has made his/her report with due care and attention and after taking into account all the relevant material?	-
3.	Do you agree with the assessment of the officer given by the Reporting Officer? (In case of disagreement, please specify the reasons.) Is there anything you wish to modify or add?	-
4.	If the Officer reported upon is a member of a Scheduled Caste/Tribe, please indicate specifically whether the attitude of the Reporting Officer in assessing the performance of the SC/ST Officer has been fair and just.	-
5.	Has the Officer any special characteristics, and/or any abilities which would justify his/her selection for special assignment or out-of-turn promotion?	-