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 days
of 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" column.
 
 
BOX 1 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
BOX 2 Employee Acknowledgement
   
   
   
   
 
  
My supervisor has reviewed this appraisal with me and:






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