Schedule-15A.353
(Relating to Sub-rule (1) of Rule 78)

Semi-annual and annual work performance evaluation form of gazetted
civil employees

Guidelines for filling the work performance evaluation form:

1. The semi-annual work performance form of this Schedule shall have to
be filled on the basis of every semi-annual period and the annual work
performance evaluation form shall have to be filled on the basis of every
fiscal year (on the basis of work carried out from the 1st day of the
month of Shrawan to the last day of the month of Ashadh (July 15 to
July 14).

2. The work performance evaluation form has been divided into the
following three sections:

Section a: Semi-annual work performance evaluation form.
Section b: Annual work performance evaluation form (evaluation by
the supervisor and the reviewer)
Section c: Evaluation by the review committee.

3. The concerned civil employee shall fill all columns from 1 to 4 specified
as to be filled by the employee, as prescribed in Section (a).

Works haveto be mentioned in short in a manner to cover all works performed by
him or her in the specified period, to the extent possible. The works so
mentioned as to have been performed by the employee have to be
included in his or her job description and in the annual action plan.
Generally, works which are not included in the job description and the
action plan and which are included in the job description and action
plan of another post shall not be filled. The form so filled, also putting
name, signature and date thereon, shall have to be registered with the
concerned office for the purpose of submitting to the specified
supervisor, within Seven days of the expiration of every period. In
submitting such a form, the employee shall also attach copies of his or
her job description and approved annual action plan. In evaluating the
semi-annual work performance evaluation form so filled by the gazetted
employee, the supervisor shall examine whether the works mentioned as
performed by the concerned civil employee are included in his or her
job description and approved action plan and the employee has
presented the description of the achievements of works specified in his
or her job description and included in the annual action plan, and shall
return it, along with his or her feedbacks to the concerned employee
within another Seven days. The annual work performance evaluation
form filled in pursuant to Rule 78B., mentioning the works performed
by the concerned employee, within the Seventh day of the month of
Shrwan each year, also putting name, signature and date thereon, shall
have to be registered for evaluation and submitted to the supervisor
within the specified time or where it has to be sent by post, it has to be
sent to the supervisor for evaluation by a registered post within the
specified time. On the basis of the semi-annual work performance
evaluation form filled in by the civil employee, the supervisor shall fill
in the portion “Evaluation of Supervisor” of Section (b) for annual work
performance evaluation within the last day of the month of Shrwan each
year.

4. After making such evaluation, the supervisor shall, putting his or her
name, post, signature and date on it, submit the work performance
evaluation form to the reviewer so that the reviewer can receive it.

5. The reviewer shall fill the portion “Evaluation of Reviewer” of Section
(c) on the basis of the annual work performance evaluation form
received from the supervisor, within the Fifteen day of the month of
Bhadra each year. The reviewer shall submit the work performance
evaluation form so filled, also putting his or her name, signature and
date on it, to the review committee.

6. If, in relation to the work performance evaluation forms submitted to the
review committee, the review committee is not satisfied with the
evaluation of the supervisor or the reviewer or both, it may seek
clarification from the reviewer or supervisor or send it back for
reconsideration, along with the grounds for re-evaluation. In relation to
the work performance evaluation forms so sent, the supervisor and the
reviewer shall make re-evaluation or set out rationale, reason, if is not
necessary to amend the evaluation made before, and submit the same to
the review committee within Three days after the receipt of the forms by
the supervisor and the reviewer. If the work performance evaluation
forms so submitted again do not contain reasonable reason or marks are
not also amended, the review committee shall make comments on this
matter and write to the concerned body to record such supervisor and
reviewer and reconsider their work performance evaluation.

7. The review committee shall evaluate the annual work performance
evaluation forms submitted also on the basis of the evaluation made by
the reviewer and the supervisor and forward them to the Public Service
Commission and the secretariat of the promotion committee within the
last day of the month of Bhadra each year.

8. In respect of a civil employee who has worked under the supervision of
more than one supervisor for one period, one who is the supervisor at
the end of that person shall fill this form for the whole period.

9. In registering the work performance evaluation form after the period as
referred to in Sub-section (6a) of Section 24A. of the Act, it has to be
registered within the current financial year. The review committee shall
reduce one mark in the work performance evaluation form so registered.
10. Where any civil employee has filled in the work performance evaluation
form in time as required to be submitted within the specified time, and
the work performance evaluation form already registered with the office
is destroyed due to fire or similar other divine calamity or natural
disaster, the incumbent evaluator shall, along with the recommendation
of the pertinent Ministry, send the work performance evaluation form
filled in by such a civil employee, accompanied also by the cause of its
destroy and evidence thereof, to the Ministry of General Administration
for approval, and upon receipt of approval from the Ministry of General
Administration , the incumbent evaluator shall cause the concerned
employee to again fill in the work performance evaluation form,
accompanied by the evidence. The evaluator shall mention the reason
for re-evaluation in, and also attach the evidence with, the work
performance evaluation form so evaluated.

11. In the course of evaluating the work performance of civil employees, the
supervisor shall make evaluation on the following basis:

(a) To give a maximum of excellent grade marks, without giving most
excellent grade marks, for one appropriate segment out of the
four segments (cost, time, quantity and quality), to a civil
employee who remains absent for more that Thirty consecutive
days without getting a leave approved or without making an
application for leave,

(b) To give a maximum of excellent grade marks, without giving most
excellent grade marks, on the ground relating to the overall
quality of work, to a civil employee who has been awarded the
punishment of censure or withholding of grade or promotion in
respect of the year in which he or she has been awarded that
punishment,

(c) In cases, except where a civil employee has obtained certification
by the Funds and Accounts Controller Office that a circumstance
beyond his or her control has arisen in relation to any advance
obtained by him or her, where the civil employee has not been
able to settle the advance within Six months, subject to the laws
in force relating for financial administration and settlement of
advances, to give a maximum of excellent grade marks, without
giving most excellent grade marks, on the ground relating to the
overall quality of work, to such an employee.

(d) Where a civil employee holding the post of Chief of Office or
Head of Department or chief of project has not been able to
achieve Fifty percent goal or result throughout the year despite
the sanction of funds and approval of programmes during the first
four monthly period of a fiscal year, to give a maximum of
excellent grade marks, without giving most excellent grade marks,
on the ground relating to the overall quality of work, to such an
employee,

(e) The goal of business to be performed by a civil employee holding
a post other than the post of Chief of Office shall be determined
by a collective meeting of employees within the first four
monthly period of each year. In making evaluation of a civil
employee who fails to achieve Fifty percent goal so determined,
to give a maximum of excellent grade marks, without giving most
excellent grade marks, on the ground relating to the overall
quantity of work as referred to in Clause (d), to such an
employee,Provided that, if the goal specified in Clauses (d) and (e)
could not be achieved due to other reason than that of the
concerned employee, the marks shall not be decreased.

(f) If there is any evidence that any civil employee has done an
undisciplined act, to give a maximum of excellent grade marks,
without giving most excellent grade marks, on the ground relating
to the overall quantity of work,

(g) To give a maximum of excellent grade marks, without giving most
excellent grade marks, on any one of the two grounds relating to
the overall quantity and quality of work to a civil employee who
does not fill up the half-yearly work performance evaluation form
within the time-limit as referred to in Sub-rule (2) of Rule 78B.
and a civil employee who does not evaluate the yearly and half
yearly work performance.

12. Where, in reducing marks on the grounds as referred to in serial number
11, marks are to be reduced in relation to the same civil employee on
more than One ground, it shall not be required to reduce marks on more
than Two grounds out of the Four grounds in One year.

13. If it appears that marks have not been reduced accordingly despite the
existence of the reasons as referred to in serial number 11, One mark
shall be reduced in the evaluation of the work performance of such an
evaluator.

14. Even if marks are to be reduced pursuant to serial number 11, there
shall be attached documents accompanied by clear reasons for the same.

15. In making work performance evaluation, the work performance
evaluator shall make such evaluation by clearly write marks in such
column of the work performance form as specified for the purpose of
giving marks

Part-A

Format of semi-annual work performance evaluation form of
gazetted civil employees
1. First semi-annual work performance evaluation form
Period of evaluation: From the month of Shrwan of year…. to the
last day of the month of Poush
Office where details are submitted to: Registration No.: Date:
Name of employee: Code of employee
Post and Class:
Service:
Group or Sub-group:
Name of the Office presently in service:
Date of appointment to the current post:
Offices transferred to during this period of evaluation (Serially):
Date of submission to the supervisor:

Signature of the employee: Date:

Note:
(1) The concerned civil employee shall fill the actual details up to columns
1, 2, 3 and 4 of the above form for the first semi-annual evaluation and
register it with the concerned office for the purpose of submitting it to
the supervisor within the Seventh day of the month of Magha every
year.
(2) A minimum of Five works have to be mentioned in the description of the
works performed.

(3) Works mentioned have to correspond to the objectives of the
organization and the job description of the post.
(4) For any work of which annual target cannot be specified at the
beginning, the works performed throughout the year shall be considered
to be the annual target.
(5) The supervisor shall make evaluation of the semi-annual evaluation form
submitted to him or her within Seven days and provide a copy of the
evaluation form to the concerned civil employee.
(6) If it is not possible to evaluate the time, evaluation shall be made by
making analysis also on the basis of the overall quantity achieved. If
description cannot be accommodated in any column, it shall be set forth
in a separate sheet and certified and attached.
(7) Evaluation shall be made by writing the marks in the column specified
for the purpose of giving marks.

Format of semi-annual work performance evaluation
form of gazetted civil employees
2. Second semi-annual work performance evaluation form
Period of evaluation: From the month of Magha of year…. to the
last day of the month of Ashadh
Office where details are submitted to: Registration No.: Date:
Name of employee: Code of employee
Post and Class:
Service:
Group or Sub-group:
Name of the Office presently in service:
Date of appointment to the current post:
Offices transferred to during this period of evaluation (Serially):
Date of submission to the supervisor:

Signature of the employee: Date:

Note:
(1) The concerned civil employee shall fill the actual details up to columns
1, 2, 3 and 4 of the above form for the second semi-annual evaluation
and register it with the concerned office for the purpose of submitting it
to the supervisor within the Seventh day of the month of Magha every
year.
(2) A minimum of Five works have to be mentioned in the description of the
works performed.

(3) Works mentioned have to correspond to the objectives of the
organization and the job description of the post.
(4) For any work of which annual target cannot be specified at the
beginning, the works performed throughout the year shall be considered
to be the annual target.
(5) The supervisor shall make evaluation of the semi-annual evaluation form
submitted to him or her within Seven days and provide a copy of the
evaluation form to the concerned civil employee.
(6) If it is not possible to evaluate the time, evaluation shall be made by
making analysis also on the basis of the overall quantity achieved. If
description cannot be accommodated in any column, it shall be set forth
in a separate sheet and certified and attached.
(7) Evaluation shall be made by writing the marks in the column specified
for the purpose of giving marks.

Part-B
Format of annual work performance evaluation form of
gazetted civil employees
Period of evaluation: Financial year:……..From the month of Shrwan to the
last day of the month of Ashadh
Office where details are submitted to: Registration No.: Date:
Name of employee: Code of employee
Post and Class:
Service:
Group or Sub-group:
Name of the Office presently in service:
Date of appointment to the current post:
Offices transferred to during this period of evaluation (Serially):
Date of submission to the supervisor:

Signature of the employee: Date:

Note:
(1) The concerned employee shall fill the actual details up to columns 1, 2,
3 and 4 of the above form for the annual evaluation and register it with
his or her office for the purpose of submitting it to the supervisor within
the Seventh day of the month of Shrwan every year.
(2) A minimum of Five works have to be mentioned in the description of the
works performed.

(3) Works mentioned have to correspond to the objectives of the
organization and the job description of the post.
(4) For any work of which annual target cannot be specified at the
beginning, the works performed throughout the year shall be considered
to be the annual target.

Evaluation by supervisor and reviewer
Date of submission to the supervisor: Date of submission to the reviewer:

If it is not possible to evaluate the time, evaluation shall be made by making
analysis also on the basis of the overall quantity achieved. If description cannot
be accommodated in any column, it shall be set forth in a separate sheet and
certified and attached. The supervisor and the reviewer shall make evaluation,
on the grounds specified in Section 24A. of the Civil Service Act and Rule 78
of the Civil Service Regulation and submit the forms to the reviewer or review
committee within the period as referred to in Rule 78B. of the Civil Service
Regulation. Reason is to be set out clearly for giving more than Ninety Five
percent and less than Seventy Five percent marks pursuant to Sub-rule (7) of
Section 24A. of the Civil Service Act. The Competent Authority shall take
departmental action against the evaluator who uses tipex over the marks
obtained.
Note:
(1) The supervisor shall, based on the semi-annual evaluation forms filled
by the civil employee, evaluate the annual work performance evaluation
form of the gazette civil employee and so submit that the reviewer
receives it within the month of Shrwan.
(2) The reviewer shall evaluate the annual work performance evaluation
form of the employee submitted to him or her and so submit that the
review committee receives it within the Fifteenth day of the month of
Bhadra.
(3) Reason is to be set out clearly for giving more than 95 percent and less
than 75 percent marks by the supervisor or reviewer for the work
performance evaluation to be made annually; and where less than 75
marks are given, information thereof shall be given to the concerned
civil employee, and if the employee makes any comments, the form shall
be accompanied also by such comments and submitted to the review
committee.

Part-C
Evaluation by the review committee
Date of submission to the review committee:
To give the mark of the same level if agreed with the evaluation made by the
supervisor and the reviewer, and in the other cases, to make evaluation by
setting out remarks:
Name of employee: Post: Class:

Review committee officials’:

Name Post Employee code Signature Total marks obtained
1. In figure:
2. In words:
3.
Note:
(1) The review committee shall evaluate the work performance evaluation
forms so received by the committee and forward them to the Public
Service Commission and the secretariat of the promotion committee
within the last day of the month of Bhadra.
(2) If the review committee is to give more than Ninety Five percent and
less than Seventy Five percent marks to any civil employee for the work
performance evaluation, clear reasons shall be assigned for the same.
The Competent Authority shall take departmental action against the
evaluator who uses tipex over the marks obtained.