Dd Form 2799 - Employee Performance Plan And Results Report Page 5

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EMPLOYEE PERFORMANCE PLAN AND RESULTS REPORT
PART D - PERFORMANCE RATING
SECTION I - IDENTIFYING INFORMATION
1. EMPLOYEE NAME (Last, First, Middle Initial)
2. RATING PERIOD
a. FROM (YYYYMMDD)
b. TO (YYYYMMDD)
3. POSITION TITLE
4. SERIES
5. GRADE
6. ORGANIZATION/DIVISION
SECTION II - EMPLOYEE SELF ASSESSMENT NARRATIVE
7. EMPLOYEE SELF ASSESSMENT NARRATIVE
SECTION III - CRITICAL ELEMENTS RATING AND SUPPORTING NARRATIVE
(Rating Official completes)
8. CRITICAL ELEMENT RATINGS (U = Unacceptable, M = Met, E = Exceeded, NR = Not Rated)
a.
b.
c.
d.
e.
9. RATING OFFICIAL NARRATIVE TO SUPPORT CRITICAL ELEMENT RATINGS
(Other than Met)
SECTION IV - SUMMARY RATING
(Apply X to one rating)
Level 4
Level 1
Level 3
Level 5
EXCEEDS
UNACCEPTABLE
FULLY SUCCESSFUL
EXCEPTIONAL
FULLY SUCCESSFUL
SECTION V - PERFORMANCE RECOGNITION
(Apply X to only one award type. Review QSI qualifications prior to recommendation.)
PERFORMANCE AWARD
AMOUNT AWARDED: $
QUALITY STEP INCREASE
FROM: STEP
TO: STEP
TIME OFF AWARD
NUMBER OF HOURS:
DD FORM 2799, DEC 2015
Page 5 of 6 Pages

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