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D:\kundan(37).k\bara babu\CabSanlekh.doc - 59 -
- \,,
/
PERFORMANCE APPRAISAL REPORT
FOR
BIHAR MI-INICIPAL (EXECUTIVE) OFFICER SERVICES
URBAN DEVELOPMENT AND HOUSING DEPARTMENT
Government of Bihar
\ rN^
PERFORMANCE APPRAISAL REPORT
FOR
BIHARM
Name of Officer:
XECUTTVB OFFICERS
Report for the year:
Period:
)N"
The Bihar Municipal (Executive) Officer Services, Performance Appraisal Report (PAR)
Performance Appraisal Report for the period from
Section I- Basic Information
(To be filled by the PAR section of Urban Development and Housing Department (UD&HD)
1. Name of the offtcer Reported upon:
2. Civil List Number/Year:
3. Date of Birth(DDA{IU/YYYY):
4. Present Grade:
5. Present Post:
6. Date of Appointment to present post:
7. Reporting, Reviewing and Accepting Authorities :
8. Period ofabsence on leave, etc :
Name & Designation Period Worked
Reporting AuthoritY
Reviewing AuthoritY
Accepting AuthoritY
On Leave (SPecifY TYPe)
Others (specifY)
9. Training Programs attended
10. Awards/ Honours
11. Date of filing the property return for the year ending December
12,Daleoflastprescribedmedicalexamination(forofficersabove40 years of age) (Attach copy of the report)
Date: Signature on behalf ofAdmn/Personnel DePartment:
Section ll - Self Appraisal(To be filled in by the Offlcer Reported upon)
(Please read carefully the instructions given at the end of the form before filling the entries)
1. Brief Description of duties
2. Annualwork plan & achievements:
Task to be performed Deliverables Actual Achievements
lnitial Mid Year
Ah^
3. During the period under report do you believe that you have made any exceptional
contribution, for exampte successfu! completion of an extraordinarily challenging task or
major systemic improvement (resulting in significant benefits to the public and/ or
reduction in time and cost)? lf so, please give a verbal description (not more than 100
words):
4. Please state briefly the shortfalls in respect of your achievement' Please specify
constraints or handicaps that you faced
5. Please indicate specific areas in which you feel the need to upgrade your skills throughtraining programs:
Declaration
Have you filed your immovable property return, as due, if yes,please mention the same
Yes / No Date
Have you undergone the prescribed medical check up? Yes / No
Have you set annual work plan for all officers for the current year'
in respect to whom you are reporting authority?Yes / No
Place:
Date:
Signature of the Officer Reported Upon
Section lll - APPraisal
(To be filled in by the Reporting Officer)
(please read carefully the instructions given at the end of the form before filling the entries)
1. please state whether you agree with the responses retating to the accomplishments of the
work plan and unforeieen tisk, as fitted outin Section !1. lf not please furnish factual
details.
2. please comment on the claim (if made) of exceptional contribution by the officer reported
upon
3. Has the officer reported upon met with any significant shortfall in respect of his work? lfyes, please furnish factual details.
4. Do you agree with the skill up-gradation needs as identified by the officer?
5. Assessment of work output (This assessment should rate the officer vis-i'vis his peers
and not the general population. Grades shoutd be assigned on a scale of 1'10, in whole
numbers, wiltr t referring to the lowest grade and 10 to the best grade. Weightage to this
section will be 40%)
Item Reportingauthority
ReviewingAuthority
!nitials ofReviewingAuthority
1 Accomplishment of Planned Work
2 Quality of OutPut
3 Accomplishment of notableachievements / unforeseen tasks during
the period
-Overall Grading on'Work OutPut'
6. Assessment of Attributes (on a scale of 1-10, weightage to this section will be 30%)'
Item Reportingauthority
ReviewingAuthority
lnitials ofReviewingAuthority
1 Attitude to work
2 Sense of resPonsibilitY
3 Overall bearing and PersonalitY
4 Emotional StabilitY
5 Communication Skills
6 Moral Courage and willingness to IaKe a
professional stand
!tem Reportingauthority
ReviewingAuthority
lnitials ofReviewingAuthority
7 Leadership qualities
I Capacity to work within deadlines
Overall Grading on Personal Attributes
7. Assessment of Functional Gompetency (on a scale of 1-10, weightage to this section willbe 30%).
8. lntegrity
Please comment on the integrity of the officer:
!tem Reportingauthority
ReviewingAuthority
lnitials ofReviewingAuthority
1 Knowledge of laws/rules/procedures/lTskills and awareness of the local normsin the relevant area
2 Strategic planning abilitY
3 Decision making ability
4 lnitiative
5 Co-ordination abilitY
6 Ability to motivate and develoPsubordinates/work in a team
Overall grading on "FunctionalCompetency"
10
9. Please comment (In about 100 words) on the overall qualities of the officerincluding areas of strengths and lesser strengths and his attitude towards weaker
section.
Overall Grading : (on a scale of I to l0)
Signature of the RePorting Officer
Date:
1.
Section IV - Review
Do you agreewith the assessment made by the reporting officer with respect to
the work output and the various attributes in section III? Do you agree with the
assessment of ttre reporting officer in respect of extraordinary achievements
and/or significant failures/sliortfall of the officer reported upon? (In case you do
not agree with any of the numerical assessments of attributes please record your
urr.ri-.nt in the column provided for you in that section and initial your
entries)
Yes I No
2. In Case of difference of opinion details and reasons for the same may be given.
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 Grading: (on a scale of I to 10)
Place :
J.
\T^
Date:
Signature of the Reviewing Officer
Section V - Acceptance
l. Do you agree with the remarks of the reporting/reviewing authorities?
Yes No
Overall Grading: (on a scale of I to 10)
Place:
Signature of the Accepting Authorities
Date:
,)
SECTION VI
PROFORMA FOR HEALTH CHECK UP
lkte:
Ser: ilUf
$6lemb
lkm
&ld clhlcal hlslory, tf anY:
ftBamlnathn
Pt{Flicd
lmn*tlsllons
lkrnsam
is6
TLC
DLC
PertplralSnru
BbodSugar
F
P.P
Uptd Proflle
ldalClolesterd
ISLCholesteml
LDL Cholederol
VI-DLGfnlesbml
Tfulcaile
\h'
15
t_, .v
Llvor F*nctlol Test
TCIlal&lirubin
Drred Bilrubin
lndircd Bilirubin
SGOT
SGPT
ALK Ph**phahse
Kldney Function Test
Urea
Creatinina
Uric Apid
Electrclytes
Na+
K
Calcium
lnorganic Fhosplule*
Cardlar Profile
CPK
CK-M8
LDI.'
SGOT
Urine
Rouline h4i***copic
$ugar
Albumin
16
8.C.0
+X-ray Chsst
Ulra Souttd Abdomen
Any other Inuestisation
Advise
B: lredi$al Rqpott Pf tfis Offiqsr
Dale
Srgnature af *ledical AuthontY
ile*ignation
i{a*$losiskt ieuel of tlre pfiicet
frlormal/HigftlLo'aCholeslerol l*vel ol the ofiicer
C: $umm*ry 0f i&dieal Report (copy to he attached to PAR)
fuly otftet tema"s based on the health
medical ch*ck uP of ihe officer
17