TFN 832 

UNITED REPUBLIC OF TANZANIA 
OPEN PERFORMANCE REVIEW AND APPRAISAL FORM 


(To be filled in Triplicate) 

From: July … …. to June … ………. 

This Form replaces all other appraisal forms in the Public Service Institutions. It is intended to meet the requirements of the 
performance management system and development process. 

NOTES ON HOW TO FILL THIS FORM: 

1. 
This Form must be filled by all employees in the Public Service Institutions. For principal officers and above, at the 
end of the year, once fully completed, the original should be sent to the Permanent Secretary (Establishments), 
duplicate to the respective Head of organisation and triplicate to the public servant concerned. All other employees 
(senior officers and below) original copy should be sent to the Chief Executive Officer of the organization, duplicate 
to the parent ministry of the specific cadre and the triplicate to the public servant concerned. 
2. 
Where appropriate, each box shall carry only one letter or figure. Letters to be in capitals. 
3. 
Personal/Agreed objectives are derived from the Organisation’s work plan (Strategic plan, Annual operating plans or 
Action plans) and are expected to be implemented in the current year. 
4. 
Sections 2, 3 and 4 of this Form shall be filled by the Appraisee in consultation with the Supervisor and sections 5-6 
in the presence of a third party if necessary. 
5. 
Please note that appraisals that are rated as 1 are the best performers and appraisals rated as 5 are the worst 
performers. These should be brought to the attention of top management and usually to the attention of the Chief 
Executive Officer of their respective Organisation. 
SECTION 1: PERSONAL INFORMATION 

Vote Code Check Number 
Vote Description 

Sub Vote Present Station 
Sub-vote description 

M F 
Name in Full 
Surname First name Middle name Gender 
Academic Qualification 
Duty Post Substantive Post 
Date of First Appointment 
D D M M Y Y Y Y 
Date of Appointment to present post 
D D M M Y Y Y Y 

Period served under 

Salary Scale 


Date of Birth 

Present Supervisor 


No. of DDMMY YYY 
Months 

Terms of Service 

DD= Day, MM= Month, YYYY= Year, F= Female, Male= Male 

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SECTION 2: PERFORMANCE AGREEMENT 

To be filled by the Appraisee in consultation with the Supervisor 

2.1 
S/N 
2.2 Agreed Objectives 2.3 Agreed Performance 
Targets 
2.4 Agreed Performance 
Criteria 
2.5 Agreed 
Resources 

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SECTION 3: MID-YEAR REVIEW (DECEMBER) MID-YEAR REVIEW (DECEMBER) 

To be filled by the Appraissee in Consultation with the Supervisor 

3.1 S/N 3.2 Agreed Objectives 
(As per Section 2) 
3.3 Progress Towards 
Target 
3.4 Factors Affecting 
Performance 

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SECTION 4: REVISED OBJECTIVES (if any) REVISED OBJECTIVES (if any) 

4.1 S/N 4.2 Agreed Revised 
Objective(s) 
4.3 Agreed 
Performance Targets 
4.4 Agreed Performance 
Criteria 
4.5 Agreed 
Resources 

4.6 Appraisee 4.7 Supervisor 
Name (in capital letters) Signed Name (in capital letters) Signed 
Date………………………….. Date………………………… 

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SECTION 5: ANNUAL PERFORMANCE REVIEW & APPRAISAL (JUNE ……) SAL (JUNE ……) 

To be filled by the Appraisee and the Supervisor 

5.1 5.2 Agreed Objective(s) 5.3 Progress made 5.4 Rated Mark 
S/N Appraise 
Super 
visor 
Agreed 
Mark 
. 
Overall Performance Mark: This should reflect the overall performance and 
achievement of agreed objectives in Section 5. 

Rating: 
1 = Outstanding performance 2 = Performance above average 3 = Average performance 
4 = Poor performance 5 = Very poor performance 

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SECTION 6: ATTRIBUTES OF GOOD PERFORMANCE 

To be filled by the Appraisee and the Supervisor 

6.1 6.2 MAIN FACTORS 6.3 QUALITY ATTRIBUTE 6.4 RATED MARK 
S/N Appraisee Supervisor Agreed 
Mark 
1 WORKING 
RELATIONSHIPS 
Ability to work in team 
Ability to get on with other staff 
Ability to gain respect from others 
2 COMMUNICATION AND 
LISTENING 
Ability to express in writing 
Ability to express orally 
Ability to listen and comprehend 
Ability to train and develop subordinates 
3 MANAGEMENT AND 
LEADERSHIP 
Ability to plan and organize 
Ability to lead, motivate and resolve conflicts 
Ability to initiate and innovate 
4 PERFOMANCE IN 
TERMS OF QUALITY 
Ability to deliver accurate and high quality 
output timely 
Ability for resilience and persistence 
5 PERFORMANCE IN 
TERMS OF QUANTITY 
Ability to meet demand 
Ability to handle extra work 
6 RESPONSIBILITY AND 
JUDGEMENT 
Ability to accept and fulfil responsibility 
Ability to make right decisions 
7 CUSTOMER FOCUS Ability to respond well to the customer 
8 LOYALTY 
Ability to demonstrate follower ship skills 
Ability to provide ongoing support to 
supervisor(s) 
Ability to comply with lawful instructions of 
supervisors 
9 INTEGRITY 
Ability to devote working time exclusively to 
work related duties 
Ability to provide quality services without 
need for any inducements 
Ability to apply knowledge abilities to benefit 
Government and not for personal gains 
Overall Performance Section 6 

Rating: 
1 = Outstanding performance 2 = Performance above average 3 = Average performance 
4 = Poor performance 5 = Very poor performance 

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SECTION 7: OVERALL PERFORMANCE (AVERAGE OF SECTIONS 5 & 6) 

COMMENTS BY APPRAISEE (if any): 

Name of Appraisee Signature Date 

COMMENTS BY OBSERVER (if any): 

Name of Observer Signature Date 

COMMENTS BY SUPERVISOR (if any): 

Name of Supervisor Signature Date 

SECTION 8: EMPLOYEE REWARDS/DEVELOPMENTAL MEASURES/SANCTIONS 

The supervisor will recommend the most appropriate reward, developmental measures or sanctions against the 
appraisee in accordance to the level of agreed performance targets. 

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