ANNEXURE III
FORM OF 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 by the department/Office)
1. Name of the Officer… … … … … … … … … … … … … … … … … … ...
2. Date of Birth… … … … … … … … … … … … … … … … … … … … ..
3. Present post and date of appointment… … … … … … … … … … … … … … …
4. Period of absence of duty on leave, training etc. during the year… … … … … … … … …
PART II
(Assessment by Initiating Officer)
General Assessment Excellent Good Satisfactory Below job
requirement
1 2 3 4 5
1. Knowledge of work:
i) Power of acquiring general information.
ii) Attention to detail.
iii) Industry and conscientiousness.
iv) Judgement.
v) Speed of disposal.
vi) Initiative.
vii) Control over subordinates.
viii) Relation with public.
ix) Integrity.
x) If officer has done any notable work
brief mention thereof may be made.
Similarly if the officer has been
reprimanded for indifferent work, brief
mention thereof should be made.
2. Any other remarks give special
comments on officer aptitude for special
work etc.
2A “Effectiveness in the development and
protection of Scheduled Castes and/or
Scheduled Tribes: -
a) Attitude towards Scheduled Caste and/or
Scheduled Tribes.
b) Sensitivity to Social Justice.
c) Ability to take quick and effective action
to prevent the quell atrocities and ensure
justice to Scheduled Castes and /or
Scheduled Tribes.
d) Effectiveness in bringing about the
development of Scheduled Castes and/or
Scheduled Tribes.
Note: - Application in cases of officers dealing with the development and protection of
Scheduled Castes and Scheduled Tribes.
Dated… … … … … … … … Signature of Initiating Officer
Name and Designation
PART---III
3. Remarks of Reviewing Authority Signature of Reviewing Officer
Dated: - … … … … … … … … … Name and Designation: - … … … … … … …
PART---IV
3. Remarks of Accepting Authority Signature of Accepting Authority
Dated: - … … … … … … … … … Name and Designation: - … … … … … … …