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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