FORM - I

(See rule - 4)

 

 

THE MIZORAM STATE GOVERNMENT EMPLOYEES

(PERFORMANCE APPRAISAL REPORT)

RULES, 2010

 

 

Performance Appraisal Report for the period from

 

to

 

 

 

 

Section I – Basic Information

(To be filled by the Administration Division/ Personnel Department)

 

 

 

1.

 

Name of the Officer reported upon:

 

 

 

 

 

 

2.

 

Services:

 

 

3.

 

Year of Entry:

 

 

 

 

 

4.

 

Date of Birth:

 

 

 

 

 

5.

 

Present Grade:

 

 

6.

 

Present post:

 

 

 

 

 

7.

 

Date of appointment to present post:

 

 

 

 

 

8.

 

Reporting  Reviewing and Accepting Authorities :

 

 

 

 

Name & Designation

Period Worked

 

 

Reporting Authority

 

 

 

 

Reviewing Authority

 

 

 

 

Accepting Authority

 

 

 

 

 

 

 

 

 

 

 

9.

Period of absence on leave, etc.

 

 

 

 

 

 

 

 

 

Period

 

Type

 

Remarks

 

 

 

On Leave (specify type)

 

 

 

 

 

Others (specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.       Training Programs attended

 

Date from

Date to

Institute

Subject

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11. Awards / Honours

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12. Details of Performance Appraisal Reports of Officers not written by the Officers as reporting/ reviewing authority for the previous year:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. Date of filling the property return for the year ending December:

 

 

 

(Note: Unless the officer reported upon submits his property return, his PAR shall not be initiated, reviewed and accepted.)

 

 

 

 

 

 

 

 

 

 

 

 

 

14. Date of last prescribed medical examination (for officers over ______________

                  40 years of age) (Attach copy of part ‘C’ of Report).

 

 

 

 

 

 

 

Date :

 

 

Signature on behalf of

 

 

 

 

 

Admn/ Personnel Deptt.

 

 

 

Section – II – self Appraisal

 

 

1. Brief  description of duties :

(Objectives of the position you hold and the tasks you are required to perform in about 100 words )

 

 

 

 

 

 

 

 

 

 

 

2.         Annual work plan and achievement:

 

Tasks to be performed

Deliverables 1(1)

Actual Achievement 2(2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1) Deliverables refer to quantitative or financial targets or verbal description of expected outputs.

 

2) Annual achievement refers to achievement against the specified deliverables in respect of each task. No explanations for divergences are to be given in this table

 

3.         During the period under report. Do you believe that you have made any exceptional contribution, e.g. successful completion of an extraordinary challenging task or; major systemic improvement (resulting in significant benefits to the public and / or reduction in time and costs? If so, please give a verbal description (within 100 words):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.  What are the factors that hindered your performance?

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Please indicate specific areas in which you feel the need to upgrade your skills through      training programs:

 

 

For the current assignment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For your future career

 

 

 

 

 

 

 

 

 

Please Note: You should send an uploaded CV, including educational qualifications acquired/ training programs attended/ publications/ special assignments undertaken, in a prescribed proforma, to the Candre Controlling/ Authority, once in 5 years, so that the records available with the Cadre Controlling Authority remain updated.

 

 

6. Declaration:

Have you filled your immovable property return, as due. If yes, please mention date.

 

Yes/ No

 

Date

Have you undergone the prescribed medical check up?

 

Yes/ No

 

 

Have you set the annual work plan for all officers for the current year, in respect of whom you are the reporting authority?

 

Yes/ No

 

 

7.  Whether any order for transfer and posting of the officer was issued by the Government   during the period under report.

 

Yes/No

 

 

7. (a) If yes, please indicate order No & date and date of joining at the new place posting

 

 

 

 

 

 

 

 

 

 

Date:

 

 

 

Signature of officer reported upon

 

                                           

           

 

 

 

 

 

Section – III – Appraisal

 

1. Please state whether you agree with the responses relating to the accomplishment of the work plan and unforeseen tasks as filled out in Section II. If not, please furnish factual details.

 

 

 

 

 

 

 

 

 

 

2. Please comment on the claim (if made) of exceptional contribution to the officer reported upon.

 

 

 

 

 

 

 

 

 

 

3. Has the officer reported upon met with any significant failures in respect of his work? If yes, please furnish factual details.

 

 

 

 

 

 

 

 

 

 

 

4. Do you agree with the skill upgraded or needs as identified by the officer?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  5. Assessment of work output (This assessment should rate the officer vi-a-vis his peers and not the general population Grades should be assigned on a scale of 1-10, in whole numbers, with referring to the lowest grade and 10 to the best grade. Weightage to this Section will be 40%)

 

 

 

 

Reporting Authority

Reviewing Authority

Initial of Reviewing Authority

i.

Accomplishment of planned work

 

 

 

 

ii.

 

Quality of output

 

 

 

iii.

Accomplishment of exceptional work/unforeseen tasks performed

 

 

 

Overall Grading on ‘Work Output’

 

 

 

 

6. Assessment of Personal Attributes (on a scale of 1-10 weightage to this Section will be 30%)

 

 

Reporting Authority

Reviewing Authority

Initial Reviewing Authority

i.

Attitude to work

 

 

 

ii.

Sense of responsibility

 

 

 

iii.

Overall bearing and personality

 

 

 

iv.

Emotional stability

 

 

 

v.

Communication skills

 

 

 

vi.

Moral courage and willingness to take a professional stand

 

 

 

vii.

Leadership qualities

 

 

 

viii.

Capacity to work in time limit

 

 

 

Overall Grading on Personal Attributes

 

 

   7. Assessment of Personal Attributes (on a scale of 1-10 weightage to this Section will be 30%)

 

 

 

 

Reporting Authority

Reviewing Authority

Initial of Reviewing Authority

i.

Knowledge of laws/rules/procedures/IT skills and awareness of the local norms in the relevant areas

 

 

 

 

ii.

 

Strategic planning ability

 

 

 

 

iii.

 

Decision making ability

 

 

 

 

iv.

 

Initiative

 

 

 

 

v.

 

Coordination ability

 

 

 

vi.

Ability to motivate and develop subordinate/work in a team

 

 

 

Overall Grading on Personal Attributes

 

 

 

 

   8. Integrity

Please comment on the integrity of the officer:

 

 

 

 

 

 

 

 

 

 

 

 

9. Pen picture by reporting Officer:  Please comment (in about 100 words) on the overall quality of the officer including areas of strength and lesser strength and his attitude towards weaker sections.

 

 

 

 

 

 

 

 

 

 

 

10. Whether any order for transfer and posting of the officer was issued by Government during the period under report? = Yes/No

 

 

(a) If yes, please comment whether the officer complied with the orders in time/without delay

(b) If No. reason for not complying with the orders.

 

 

 

 

 

 

 

 

 

 

 

11.       Overall grade (on a score of 1-10)

 

 

 

 

 

Date

 

 

 

Signature of Reporting Authority

 

 

 

 

 

                           

 

 

 

 

 

 

 

 

 

 

 

Section – IV-Review

 

Do you agree with the assessment made by reporting officer with respect to the output and the various attributes in section-III? Do you agree with the assessment of the reporting officer in respect of extraordinary achievements and/ or significant failures of the MOS/officer reported upon?

(in case you do not agree with any of the numerical assessment of attributes please record your assessment in the column provided for you in that section and initial entries)

Yes/No

 

 

 

 

 

 

 

 

 

 

 

 

 

In case of different of opinions details and reasons for the same may be given.

 

 

 

 

 

 

 

 

 

 

 

 

 

Pen picture by Reviewing Officer:   Please comment (in about 100 words) on the overall qualities of the officer including areas of strengths and lesser strengths and his attitude towards weaker section.

 

 

 

 

 

 

 

 

 

 

 

 

 

Overall grade on a score of 1-10

 

 

 

Date

 

 

Signature of Reviewing Authority

 

           

 

Section-V-Acceptance

 

1. Do you agree the remarks of the reporting/reviewing authorities?

Yes/No

 

 

 

 

 

 

 

 

 

 

 

 

2. In case of difference of opinion details and reasons for the same may be given.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Overall grade on a score of 1-10

 

 

 

Date

 

 

Signature of Accepting Authority