The Personnel Board of Jefferson County Alabama

7 Digit Employee ID or Last 4 of SSN
 
Employee Name
 
Jurisdiction
 
Status
 
Class Title
 
Merit Increase Date
(must be within + - 8 daysof the anniversary date) N/A if not applicable)
 

Period applicable to this appraisal from _______________ to _______________

How To Use This Form

Step 1: Supervisor (Rater) completes task statement review (see page 2 of this form).
Step 2: Rater reviews performance appraisal with higher level management official. Rater and management official sign Box #1 following review.
Step 3: Rater reviews performance appraisal with employee. Employee signs Box #2 reflecting agreement/disagreement.
Step 4: Return form to Personnel Board of Jefferson County 2121 8th Avenue North Suite 100; Birmingham, AL 35203

Review Acknowledgement

This employee received a total of _________ marks in the "Below Expectations
Management Approvals
Rater Signature
Rating Date
Rater (Print Name Here)
Rater's Phone #
Rater's Email Address
Rater's Employee ID#
Management Official's Signature
Date
Employee Acknowledgement
My supervisor has reviewed this appraisal with me and:


(You may attach supporting documents)

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