Free 51568.pdf - Indiana

State Form 51568 (3-04)

INDIANA CONSERVATION FIELD OFFICER PERFORMANCE APPRAISAL REPORT
Name of employee, Last, First, MI: Name of state agency: Social Security number Org code Review period (month / year)

Name:

IDNR, Law Enforcement
Class title and class code of employee:

Type of Evaluation

Annual

3-Month

6-Month

Follow-up

Other

Instructions For each applicable responsibility, assign the most suitable performance rating. Substantiate ratings of `Unsatisfactory" on the Comments Report

Law Enforcement Responsibilities Hunting Enforcement Satisfactory Unsatisfactory Fishing Enforcement Satisfactory Unsatisfactory Boating Enforcement Satisfactory Unsatisfactory DNR Property Enforcement Satisfactory Unsatisfactory ORV & Snowmobile Enforcement Satisfactory Unsatisfactory Investigative Duties Satisfactory Unsatisfactory Overall Law Enforcement Performance Satisfactory Unsatisfactory Educational / Public Appearance Responsibilities Hunter Education Program Satisfactory Unsatisfactory Boater Education Program Satisfactory Unsatisfactory Snowmobile Education Program Satisfactory Unsatisfactory Trapper Education Program Satisfactory Unsatisfactory Conservation Groups ­ PA's Satisfactory Unsatisfactory Community Groups ­ PA's Satisfactory Unsatisfactory School Groups ­ PA's Satisfactory Unsatisfactory Overall Educational / PA Performance Satisfactory Unsatisfactory Administrative Responsibilities Case Reports Satisfactory Unsatisfactory Arrest & Warning Citations Satisfactory Unsatisfactory Dispositions (timely submission) Satisfactory Unsatisfactory Monthly Activity Reports Satisfactory Unsatisfactory Mileage Reports Satisfactory Unsatisfactory Equipment Usage Reports Satisfactory Unsatisfactory Other Reports Not Specifically Listed Satisfactory Unsatisfactory
(Accident, Fish Kill, Lost-Stolen-Damaged etc..)

Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

Overall Administrative Performance

Satisfactory

Unsatisfactory

Overall Job Knowledge and Skill Dependability Motivation Employee Initial

General Responsibilities Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Superior Initial

Not applicable Not applicable Not applicable

Evaluator Initial

Indiana Conservation Field Officer Performance Appraisal Report - Page 2
General Responsibilities Continued Personal Appearance Satisfactory Unsatisfactory Equipment Appearance / Maintenance Satisfactory Unsatisfactory Composure / Stability Satisfactory Unsatisfactory Radio Communications Satisfactory Unsatisfactory Service & Public Relations Satisfactory Unsatisfactory Inter-Departmental / Agency Relations Satisfactory Unsatisfactory Follows Proper Procedures / Judgment Satisfactory Unsatisfactory Overall General Responsibility Satisfactory Unsatisfactory Performance Total Overall Job Performance Satisfactory Unsatisfactory Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

I hereby certify that I have had an opportunity to review this report and understand that I am to receive a copy. I am aware that my signature does not necessarily mean that I agree with the rating.

I hereby certify that this rating report constitutes my best judgment of the service performed by this employee for the review period covered.

Signature of Employee

Date signed

Signature of Evaluator

Date signed

Signature of Superior

Signature of Appointing Authority