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ABC Company Performance Appraisal Name: _____________________________ Date: ______________________________ Department: ________________________ Job Title: ___________________________ Annual Review

Date: _________________ Date of Last Review: _________________ Reviewer: __________________________ Instructions Please check the box that best describes the employees performance in the following areas: Definitions: Exceptional/Consistently Exceeds Requirements: Employee regularly made exceptional contributions that had a significant and positive impact on the performance of the department. Employee has mastered all job related skills and possesses a broad range of capabilities. Employee provides a model for excellence and helps others to do their jobs better. Frequently Exceeds Requirements: Employee frequently exceeded all performance expectations/objectives. Employee is highly skilled in all aspects of the job. Consistently Meets Requirements: Employee consistently met all expectations/objectives and occasionally exceeded some. Is fully qualified in all aspects of the job. Sometimes Fails to Meet Requirements: Employee has not consistently met all of the job requirements and/or expectations and occasionally demonstrated unsatisfactory behaviors/results. May have the ability to perform most aspects of the job but may lack some knowledge/skills to perform others. Needs Immediate Improvement: Employee frequently performs in an unsatisfactory manner and requires a performance improvement plan. Attitude (In general, towards coworkers, towards job) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Attendance (Unplanned absences/tardiness: Exceptional = 0 times, Frequently Exceeds = 1-3 times, Meets = 4-6 times, Needs Improvement = >6 times) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements

_____ Consistently Meets Requirements _____ Needs Immediate Improvement Appearance (Adherence to the dress code policy) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Communication Skills (In general both verbal and written) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Follow Through (When asked to complete a task, does so without supervisor needing to follow-up on request) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Service Standards (Adherence to Service Standards) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Quality of work (Work produced reflects standard of excellence) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Job knowledge (Maintains appropriate knowledge of policies/procedures, work related processes/technology, etc.) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements

_____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Relationship Skills (Expresses emotions appropriately, initiates friendly interactions, interacts effectively with leadership, accepts feedback, faces and resolves conflict) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Overall output (Volume of work produced) _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Overall performance _____ Exceptional/Consistently Exceeds Requirements _____ Frequently Exceeds Requirements _____ Consistently Meets Requirements _____ Sometimes Fails to Meet Requirements _____ Needs Immediate Improvement Employee Developmental Plan (include continuing educational needs): _______________________________________________________________ Employee Goals: _________________________________________________ Employee Comments: _____________________________________________ Supervisor Comments: ____________________________________________ Your signature only indicates that this evaluation has been discussed with you. It does not state your agreement or disagreement with this evaluation. Employee Signature: _____________________ Date: ______________ Supervisor Signature: ____________________ Date: ______________ Human Resources Signature: _______________ Date: ______________ For HR Use only: Current Rate:________ % Merit Increase_____ New Rate: _________ Effective Date of Increase: _________ Original: Human Resources

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