GOVERNMENT OF HARYANA
FORM OF ‘ANNUAL CONFIDENTIAL REPORT’
(For the common cadre group ‘D’ posts)
Department:
Office/Branch/Section:
Period under Report:
Part-1
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 and obedience
7. Intelligence and fitness to do the assigned tasks.
8. Whether employee stays at his Headquarters after closing of office and
during holidays?
9. Assessment of Integrity.
10. Whether there are any ‘Adverse Remarks’ on the work and conduct of
the employee? Reply in “Yes” or “No”. If yes, please give details.
11. Suitability for promotion or Higher Scale of pay.
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 Reviewing Authority
Name in Block letters
Designation
Date
REMARKS IF ANY, OR COUNTER SIGNATURES 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.
(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. 10
and nothing be written along with the box-block meant for Grading only.
4. While recording remarks on ‘Integrity’ in column at Sr. No. 09. instructions contained in
para 4 of Consolidate Instructions on confidential reports. Read with instructions No.
61/20/85-S (1), dated 12-12-1985 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 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 and reflected in his day to day official work during the period under report.
7. Signatures in full along with date be put up by the Reporting/Reviewing/Accepting
Authorities.
