XXXXXXXXXX Limited Performance Evaluation Form Department : Administration Review Period : 01/01/04 to 30/11/04 Employee Name D esignation Qualification

Date of Birth Part A: Please assess your performance in the following areas in terms of your current role requirements based on the rat ings, Exceeds Expectations (4) Meets Expectations (3) Meets Minimal Requirements (2) Unable to meet Requirements (1) Self Supervisors Appraisal Appraisal Rating Rating : : : : Date of Joining Location : : Employment Status : Probationary/Confirmed Rating Factors Personal Traits V Versatility I Interaction with staff members B Building Company image H Honesty A Accountability Job Competency 1. Ability to d raft 2. Follow up of activities 3. Ability to meet targets within deadlines 4. O perating skills 5. Maintenance of records 6. Organizing the work effectively 7. Ability to foster a cooperative work environment 8. Ability to investigate and a nalyze the situations to draw conclusions 9. Grievance handling Justification

10. 11. 12. 13. Statutory knowledge Monitoring skills Counseling skills MIS management 14. Coordinating with functional heads 15. Liaising between employees and management 16. Promptness in submission of re ports 17. Economy in use of Company resources 18. Human Resource Planning 19. Re cruitment handling 20. Designing the formats 21. Upholding the formal communicat ion process 22. Negotiating skills General Attitude 1. Punctuality 2. Attendance 3. Personal appearance 4. Communication skills 5. Decision making skills 6. Emo tional stability 7. Striving for new knowledge 8. Self discipline 9. Diplomacy 1 0. Commitment to work Part B: 1) Please list the major responsibilities of your job in order of import ance. 2) What do you consider to be the most important achievements of your career thi s year?

3) What additional responsibilities you would like to take in the next year? 4) What motivates you, a) Increment b) Secure Employment c) Designation d) Promotion e) Recognition f) Creative and Challenging work g) Role Expansion h) Training and Development 5) Have you acquired any other qualification in this year, if so please specify. 6) Please specify the Appreciation(s) (if any) you received from the Management in the review period. 7) Please state the Additional activities you have involved related to your job in the review period. 8) What elements of your job interest you the most and why? 9) What elements of your job do you find most difficult and why? 10) Is there any Grievance that you wish to bring to the notice of the Managemen t? (Please do not hesitate, if genuine, the same will be looked into)

11) Your goal in the Organisation in near future. By Designation Salary 12) What sort of training/experience would benefit you in the next year? 2005 2006 2007 13) Please specify the problems (if any) beyond your control, which have affecte d your ability and efficiency. ------------------------------------Employee Signature Date: Appraiser Comments: ------------------------------------Appraiser Signature Date: