GOVERNMENT OF HARYANA

FORM OF ‘ANNUAL CONFIDENTIAL REPORT’

(For Clerks and other posts of similar nature in Group ‘C’)

Department of Economic & Statistical Analysis Haryana, Panchkula

Office/Branch/Section : ____________________________________________________________
Period under Report : ______________________________________________________________
Part-I
1. Name of the employee : ______________________________________________________
2. Father’s Name : ____________________________________________________________
3. Designation of the post held : _________________________________________________

Reporting Reviewing Accepting

Authority _____________________ Authority _______________ Authority _________________
Part-II
Important Notes : 1. Before writing the Annual Confidential Report, the Reporting/Reviewing/
Accepting Authorities should read carefully the instructions given in the
end of the form
2. Unless otherwise specified to the contrary, the Reporting Authority should
make use of one of the gradings, i.e. ‘Outstanding’, ‘Very Good’, ‘Good’,
‘Average’, ‘Below Average’ in the box-blocks provided against each column.
----------

1. Brief of duties assigned _____________________________________

2. State of Health _____________________________________

3. Conduct and Character _____________________________________

4. Punctuality and Regularity in

attendance _____________________________________

5. Ability to get along and ____________________________________

behavior with

(a) Superior Officers (a) _____________________________________

(b) Colleagues (b) _____________________________________

(c) Public (c) _____________________________________

6. Amenability to Discipline _____________________________________

7. Devotion to duty and

hardworking _____________________________________

8. General Intelligence and

keenness to learn
_____________________________________
9. Knowledge about Department ,
Branch and Office procedure _____________________________________

…………2
 -2-

Name & Designation of the official_____________________

10. Proficiency in use of State

Language ‘Hindi’ in his day _____________________________________
to day official work.
11. Whether the employee stays at
his Headquarters after closing _____________________________________
of office and during holidays ?

12. Proficiency and accuracy in _________________________________

typing

13. Proficiency in work of maintenance ____________________________________

Of Registers, Files and other record

14. Initiative and willingness o perform ____________________________________

Any job of responsibility

15. Assessment of Integrity: ____________________________________

Has any things come to your notice which
Reflect adversely on the official’s integrity
or his ability to honestly execute his duties?
Reply in ‘Yes’ or ‘No’

If yes please give details.

16. Whether there are any ‘adverse remarks ____________________________________

on the work and conduct of the
employee? Reply in ‘Yes’ or ‘No’

If yes please give details.

17. Has the official done any outstanding ______________________________________

or notable work meriting?
Reply in ‘Yes’ or ‘No’

If yes please give details.

18. Suitability for promotion or ______________________________________

Higher Scale of pay

19. “Whether the officer/official delivers the _____________________________________

services or dispose of the case in a given
time frame ? (Reply in ‘Yes’ or ‘No’)

20. Overall Grading based on the _____________________________________

Assessment made from
Sr.No. 2 to 13

Signature of the Reporting Authority

Name in block letters : ___________________
Designation : __________________________
Date :

…….3…
 -3-

REMARKS OF THE REVIEWING AUTHORITY

(Tick one of these three items (a) I endorse the above remarks.
(a), (b) & (c) and strike out the
remaining two). (b) I generally agree with the above views
subject to the following observations.
_____________________________________
(c ) I do not agree with the above remarks
in column : ____________________________
Signature of the Reviewing Authority
Name in block letters : ___________________
Designation : __________________________
Date :
Remarks, if any, or countersignatures of the Accepting Authority.

Signature of the Accepting Authority

Name in block letters : ___________________
Designation : __________________________
Date :
IMPORTANT INSTRUCTIONS FOR FILLING IN THE FORM
1. The following prescribed time Schedule for writing Annual Confidential Report may
strictly be adhered to:
(a) The Reporting Authority must write the report before 15th April;
(b) The Reviewing Authority must record its comments before 30th April; and
(c) The Accepting Authority must record its acceptance before 15th May.
2. The Reporting Authority should use the prescribed terminology for each item and
write one of the choice in the box-block mentioned against these items.
3. The Reporting Officer should record ‘adverse remarks’ if any, in column at Sr. No.
17 and nothing be written alongwith the box-block meant for Grading only.
4. While recording remarks ‘Integrity’ in column at Sr. No. 16, instructions contained
in para 4, of Consolidating instructions on confidential reports, read with instructions
No. 61-20-85-S(I), dated 12.12.85 must be gone through carefully.
5. The Reporting Officer should make a mention of any defects noted and any
punishment inflicted on the employee or written warning(s) issued to him during the
period under report to give any correct picture of his work and conduct.
6. The Report should be a true and objective assessment of the employee’s ability and
character as reflected in his day to day official work during the period under repot.
7. Signatures in full alongwith date be put up by the Reporting/Reviewing/Accepting
Authorities.
 GOVERNMENT OF HARYANA
FORM OF 'ANNUAL CONFIDENTIAL REPORT' OF DRIVERS
(Application for Drivers of staff Cars/Jeeps and other official vehicles)

Department of Economic & Statistical Analysis Haryana, Panchkula

Office of the ______________________________

Period of Report ______________________________

PART- I

1. Name of the employee ______________________________

2. Father's Name ______________________________

3. Date of continuous appointment ______________________________

on the post of Driver.

Reporting Reviewing Accepting

Authority ______________ Authority________________ Authority________________

PART-III

Important Notes:- 1. Before writing the Annual Confidential

Report, the Reporting/Reviewing/Accepting
Authorities should read carefully the instructions given
at page 2 of this form.

2. Unless otherwise specified to the contrary the

Reporting Authority should make use of one of the
grading i.e. 'outstanding', 'Very good', 'Good',
'Average', 'Below Average' in the Box-Blocks provided
against each column.

1. State of Health ______________________________

2. Punctuality and Devotion to duty ______________________________

3. Ability to get along and behaviour with

i) Superior Officers i) ______________________________
ii) Colleagues ii) ______________________________

4. Whether the employee stays at his head- ______________________________

quarter after closing of office and during
holidays (Reply in 'Yes' of 'No').

5. Technical Knowledge about the vehicle _____________________________

which he drives.

6. Proficiency in safe driving and main- ______________________________

tenance of the vehicle.

7. Acquitance with traffic rules and ______________________________

other road signs.

……………2
 -2-

Name & Designation of the official_____________________

8. Does he maintain the log book according ______________________________

to Govt. instructions ?
(Reply in 'Yes' or 'No' ).

9. Assessment of Integrity: ______________________________

Has anything come to your notice
which reflect adversely on the official's
integrity. Reply in 'Yes' or 'No'. If
Yes, please give details.

10. Any other comments. ______________________________

11. “Whether the officer/official delivers the ______________________________

services or dispose of the case in a given
time frame ? (Reply in ‘Yes’ or ‘No’)

12. Overall grading based on the ______________________________

assessment made from Sr.No.2
to 10.

Signature of the Reporting Authority

Name in block letters________________________
Designation________________________________
Date _____________________________________

REMARKS OF THE REVIEWING AUTHORITY

Signature of the Reporting Authority

Name in block letters________________________
Designation________________________________
Date _____________________________________
 GOVERNMENT OF HARYANA

FORM OF ‘ANNUAL CONFIDENTIAL REPORT’

(For the Common Cadre Group ‘D’ posts)

Department of Economic & Statistical Analysis Haryana, Panchkula

Office/Branch/Section : ____________________________________________________________
Period under Report : ______________________________________________________________
Part-I
1. Name of the employee : ______________________________________________________
2. Father’s Name : ____________________________________________________________
3. Designation of the post held : _________________________________________________

Reporting Reviewing Accepting

Authority _____________________ Authority _______________ Authority _________________
Part-II
Important Notes : 1. Before writing the Annual Confidential Report, the Reporting/Reviewing/
Accepting Authorities should read carefully the instructions given in the end
of this form
2. Unless otherwise specified to the contrary, the Reporting Authority should
make use of one of the gradings, i.e. ‘Outstanding’, ‘Very Good’, ‘Good’,
‘Average’, ‘Below Average’ in the box-blocks provided against each column.
----------

1. State of Health _____________________________________

2. Conduct and Character _____________________________________

3. Punctuality and Regularity in

attendance _____________________________________

4. Amenability to Discipline _____________________________________

5. Devotion to duty and

hardworking _____________________________________

6. Behaviour & Obedience

_____________________________________
(a) Attitude of the Officer/
Official towards other castes and _____________________________________
Communities.

7. Intelligence and fitness to do the

assigned tasks. _____________________________________

8. Whether employee stays at his Head-

Quarters after closing of office and _____________________________________
during holidays?
Reply in ‘Yes’ or ‘No’ _____________________________________

9. Assessment of Integrity : _____________________________________

10. Adverse remarks on work performance ____________________________________

and conduct, if nay. Reply in ‘Yes’
or ‘No’
……….2
 -2-
Name & Designation of the official_____________________

11. Suitability for promotion or Higher _____________________________________

scale of pay (use term ‘Fit’ or “Not
yet Fit’ or ‘Not Fit’)

12. “Whether the officer/official delivers the _____________________________________

services or dispose of the case in a given
time frame ? (Reply in ‘Yes’ or ‘No’)

13. Overall Grading based on the assess-

ment made from Sr.No. 2 to 10 above. _____________________________________

Signature of the Reporting Authority

Name in block letters : ___________________
Designation : __________________________
Date :_________________________________

REMARKS, IF ANY, OR COUNTERSIGNATURES OF THE REVIEWING/ACCEPTING

AUTHORITY
________________________________________________________________________________

Signature of the Reviewing /Accepting Authority

Name in block letters : ___________________
Designation : __________________________
Date :_________________________________

IMPORTANT INSTRUCTIONS FOR FILLING IN THE FORM

1. The following prescribed time Schedule for writing Annual Confidential Report may
strictly be adhered to:

(a) The Reporting Authority must write the report before 15th April;
(b) The Reviewing Authority must record its comments before 30th April; and
(c) The Accepting Authority must record its acceptance before 15th May.

2. The Reporting Authority should use the prescribed terminology for each item and
write one of the choices in the box-block mentioned against these items.

3. The Reporting Officer should record ‘Adverse Remarks’ if any, in column at Sr. No.
17 and nothing be written alongwith the box-block meant for Grading only.

4. While recording remarks on ‘Integrity’ in column at Sr.No. 9, instructions contained

in para 4, of ‘Consolidated’ instructions on confidential reports, read with
instructions No. 61/20/85-S(I) dated 12.12.85, must be gone through carefully.

5. The Reporting Officer should make a mention of any defects noted and any
punishments inflicted on the employee or written warning(s) issued to him during the
period under report to give a correct picture of his work and conduct.

6. The Report should be a true and objective assessment of the employee’s ability and
character as reflected in his day to day official work during the period under Repot.
7. Signatures in full alongwith date be put up by the Reporting/Reviewing/Accepting
Authorities.
 GOVERNMENT OF HARYANA

FORM OF ‘ANNUAL CONFIDENTIAL REPORT’

(For Assistants and other posts of similar nature in Group ‘C’)

Department of Economic and Statistical Analysis, Haryana

Office/Branch/Section : ____________________________________________________________
Period under Report : ______________________________________________________________
Part-I
1. Name of the employee : ______________________________________________________
2. Father’s Name : ____________________________________________________________
3. Designation of the post held : _________________________________________________

Reporting Reviewing Accepting

Authority _____________________ Authority _______________ Authority _________________
Part-II
Important Notes : 1. Before writing the Annual Confidential Report, the Reporting/Reviewing/
Accepting Authorities should read carefully the instructions given in the
end of the form
2. Unless otherwise specified to the contrary, the Reporting Authority should
make use of one of the gradings, i.e. ‘Outstanding’, ‘Very Good’, ‘Good’,
‘Average’, ‘Below Average’ in the box-blocks provided against each column.
----------

1. Brief of duties assigned _____________________________________

2. State of Health _____________________________________

3. Conduct and Character _____________________________________

4. Punctuality and Regularity in

attendance _____________________________________

5. Ability to get along and

behaviour with _____________________________________

(a) Superior Officers (a) _____________________________________

(b) Colleagues (b) _____________________________________

(c) Public (c) _____________________________________

6. Amenability to Discipline _____________________________________

7. Devotion to duty and

hardworking _____________________________________

8. General Intelligence and

keenness to learn _____________________________________
9. Knowledge about Department,
Branch and Office procedure _____________________________________

…………2
 -2-
Name & Designation of the official____________________________

10. Proficiency in use of State

Language ‘Hindi’ in his day _____________________________________
to day official work.
11. Whether the employee stays at
his Headquarters after closing _____________________________________
of office and during holidays ?
Reply in ‘Yes’ or ‘No’.
12. Promptness and Accuracy in
disposal of work _____________________________________
13. Knowledge of Rules, Regulations
and Instructions in general and with _____________________________________
particular reference to the work
allotted to him.
14. Quality of work
(Delete the sub-clause(s) which
is/are not related to his work).
(a) Ability to apply the relevant (a) _____________________________________
Rules and Regulations correctly
(b) Capacity for examining cases (b) _____________________________________
thoroughly and comprehensiveness
(c) Quality of Noting & Drafting (c) _____________________________________
(d) Proficiency in case handling (d) _____________________________________
(e) Proficiency in Store Management (e) _____________________________________
(f) Proficiency in Accounts Matt ers (f) _____________________________________
15. Organisation of work :
(a) Retrieval of papers/information (a) _____________________________________
references
(b) Keeping the work place tidy (b) _____________________________________
and the record systematic
16. Assessment of Integrity :
Has anything come to your notice
which reflect adversely on the _____________________________________
official’s integrity or his ability to
honestly execute his duties ?
Reply in ‘Yes’ or ‘No’.
If ‘Yes’, please give details. _____________________________________
17. Whether there are any ‘adverse
remarks’ on the work and conduct _____________________________________
of the employee ?
Reply in ‘Yes’ or ‘No’.
If ‘Yes’, please give details. _____________________________________
18. Has the official done any outstanding
or notable work meriting ? _____________________________________
Reply in ‘Yes’ or ‘No’.
If ‘Yes’, please give details. _____________________________________
19. Suitability for promotion or Higher _____________________________________
scale of pay (use term ‘Fit’ or “Not
yet Fit’ or ‘Not Fit’)
……..3
 -3-
Name & Designation of the official_____________________

20. “Whether the officer/official delivers the _____________________________________

services or dispose of the case in a given
time frame ? (Reply in ‘Yes’ or ‘No’)

21. Overall Grading based on the assessment

made from Sr.No. 2 to 18 above. _____________________________________

Signature of the Reporting Authority

Name in block letters : ___________________
Designation : __________________________
Date :

REMARKS OF THE REVIEWING AUTHORITY

(Tick one of these three items (a) I endorse the above remarks.
(a), (b) & (c) and strike out the
remaining two). (b) I generally agree with the above views
subject to the following observations.
_____________________________________
(c ) I do not agree with the above remarks
in column : ____________________________
Signature of the Reviewing Authority
Name in block letters : ___________________
Designation : __________________________
Date :
Remarks, if any, or countersignatures of the Accepting Authority.

Signature of the Accepting Authority

Name in block letters : ___________________
Designation : __________________________
Date :
IMPORTANT INSTRUCTIONS FOR FILLING IN THE FORM
1. The following prescribed time Schedule for writing Annual Confidential Report may strictly
be adhered to:
(d) The Reporting Authority must write the report before 15th April;
(e) The Reviewing Authority must record its comments before 30th April; and
(f) The Accepting Authority must record its acceptance before 15th May.
2. The Reporting Authority should use the prescribed terminology for each item and write one
of the choice in the box-block mentioned against these items.
3. The Reporting Officer should record ‘adverse remarks’ if any, in column at Sr. No. 17 and
nothing be written alongwith the box-block meant for Grading only.
4. While recording remarks ‘Integrity’ in column at Sr. No. 16, instructions contained in para
4, of Consolidating instructions on confidential reports, read with instructions No. 61-20-85-
S(I), dated 12.12.85 must be gone through carefully.
5. The Reporting Officer should make a mention of any defects noted and any punishment
inflicted on the employee or written warning(s) issued to him during the period under report
to give any correct picture of his work and conduct.
6. The Report should be a true and objective assessment of the employee’s ability and
character as reflected in his day to day official work during the period under repot.
7. Signatures in full alongwith date be put up by the Reporting/Reviewing/Accepting
Authorities.
 GOVERNMENT OF HARYANA
FORM OF ‘ANNUAL CONFIDENTIAL REPORT’
(For Steno-typists Junior Scale Stenographer and Senior Scale Stenographers/P.As)

Department of Economic & Statistical Analysis Haryana, Panchkula

Office/Branch/Section : ____________________________________________________________
Period under Report : ______________________________________________________________
Part-I
4. Name of the employee : ______________________________________________________
5. Father’s Name : ____________________________________________________________
6. Designation of the post held : _________________________________________________

Reporting Reviewing Accepting

Authority _____________________ Authority _______________ Authority _________________
Part-II
Important Notes : 1. Before writing the Annual Confidential Report, the Reporting/Reviewing/
Accepting Authorities should read carefully the instructions given in the
end of the form
2. Unlesses otherwise specified to the contrary, the Reporting Authority should
make use of one of the gradings, i.e. ‘Outstanding’, ‘Very Good’, ‘Good’,
‘Average’, ‘Below Average’ in the box-blocks provided against each column.
----------

1. State of Health

2 Conduct and Character

3 Punctuality and Regularity in

attendance
4 Ability to get along and
behaviour with

(a) Superior Officers (a)

(b)Colleagues (b)

(c) Public (c)

5 Amenability of Discipline

6 Devotion to duty and

Hardworking

7 General Intelligence and keenness to

learn
8 Knowledge about Department,
Branch and Office procedure

9 Proficiency in use of State Language

Hindi in his day to day official work.

…………2
 -2-
Name & Designation of the official_____________________
10 Whether employee stays at his
Headquarters after closing of office
and during holidays?
Reply in ‘Yes’ or ‘No’
11 Proficiency in Stenography and
typing
12 Maintenance of engagement diary
and timely submission of necessary
papers for meetings, interviews etc.
13 Trust worthiness in handling secret
and top secret matters and papers
14 Handling of Dak, Files, record and
management and his office

15 Handling telephones, visitors, tour

programmes and engagements etc.

16 Assistance provided in making his

officer more effective (checking on
details) follow ups feed back progress
etc.
17 Assessment of Integrity. Has
anything come to your notice which
reflect adversely on the official’s
integrity or his ability to honestly
execute his duties? Reply in ‘Yes’ or
‘No’.

If ‘Yes’, please give details

18 Whether there are any ‘adverse
remarks’ on the work and conduct of
the employee?
Reply in ‘Yes’ or ‘No’.
If ‘Yes’, please give details.
19 Has the official done any outstanding
or notable work meriting?
Reply in ‘Yes’ or ‘No’.

If ‘Yes’, please give details.

20 Suitability for promotion or Higher

scale of pay (use term ‘Fit’ or “Not
yet ‘Fit’ or ‘Not yet Fit’ or ‘Not fit’)
21 Whether the official delivers the
services or dispose of the case in a
given time frame? (Reply in ‘Yes” or
“No”.)
22 Overall Grading based on the
assessment made from Sr. No. 2 to 19
above.

Signature of the Reporting Authority

Name in block letters : ___________________
Designation : __________________________
Date :
………….3
 -3-
Name & Designation of the official_____________________

REMARKS OF THE REVIEWING AUTHORITY

(Tick one of these three items (a) I endorse the above remarks.
(a), (b) & (c) and strike out the
remaining two). (b) I generally agree with the above views
subject to the following observations.
_____________________________________
_____________________________________

(c ) I do not agree with the above remarks

in columns : ____________________________

Signature of the Reviewing Authority

Name in block letters : ___________________
Designation : __________________________
Date :
REMARKS, IF ANY, OR COUNTERSIGNATURES OF THE ACCEPTING AUTHORITY.

Signature of the Accepting Authority

Name in block letters : ___________________
Designation : __________________________
Date :
IMPORTANT INSTRUCTIONS FOR FILLING IN THE FORM

1. The following prescribed time Schedule for writing Annual Confidential Report may
strictly be adhered to:

(a) The Reporting Authority must write the report before 15th April;

(b) The Reviewing Authority must record its comments before 30th April; and

(c) The Accepting Authority must record its acceptance before 15th May.

2. The Reporting Authority should use the prescribed terminology for each item and write
one of the choice in the box-block mentioned against these items.

3. The Reporting Officer should record ‘adverse remarks’ if any, in column at Sr. No. 17
and nothing be written alongwith the box-block meant for Grading only.

4. While recording remarks ‘Integrity’ in column at Sr.No. 16, instructions contained in

para 4, of Consolidating instructions on confidential reports, read with instructions No.
61-20-85-S(I), dated 12.12.85 must be gone through carefully.

5. The Reporting Officer should make a mention of any defects noted and any punishment
inflicted on the employee or written warning(s) issued to him during the period under
report to give any correct picture of his work and conduct.

6. The Report should be a true and objective assessment of the employee’s ability and
character as reflected in his day to day official work during the period under repot.

7. Signatures in full alongwith date be put up by the Reporting/Reviewing/Accepting

Authorities.
--------
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