+-----------------------+----------+-----------+----------------------+
| 1\. **POST:**         |          | **FOREIGN |                      |
|                       |          | SERVICE   |                      |
| **AGENCY:**           |          | OF        |                      |
|                       |          | TH        |                      |
| **ORGANIZATION:**     |          | E**![](me |                      |
|                       |          | dia/image |                      |
|                       |          | 1.wmf){wi |                      |
| **POSITION TITLE:**   |          | dth="0.38 |                      |
|                       |          | 680555555 |                      |
|                       |          | 555557in" |                      |
| **EMPLOYEE            |          | heig      |                      |
| GRADE/STEP:**         |          | ht="0.419 |                      |
|                       |          | 444444444 |                      |
| **POSITION GRADE &    |          | 44445in"} |                      |
| NUMBER:**             |          |           |                      |
|                       |          | **UNITED  |                      |
|                       |          | STATES OF |                      |
|                       |          | AMERICA** |                      |
|                       |          |           |                      |
|                       |          | #  WORK   |                      |
|                       |          |  PLAN AND |                      |
|                       |          |           |                      |
|                       |          | **PE      |                      |
|                       |          | RFORMANCE |                      |
|                       |          | E         |                      |
|                       |          | VALUATION |                      |
|                       |          | REPORT**  |                      |
+-----------------------+----------+-----------+----------------------+
| **2.** **NAME OF      |          | **3.**    |                      |
| RATED EMPLOYEE**      |          | **TYPE OF |                      |
| [(Surname             |          | REPORT**  |                      |
| first)]{.underline}   |          | [(Check   |                      |
|                       |          | ap        |                      |
|                       |          | propriate |                      |
|                       |          | box):]{.u |                      |
|                       |          | nderline} |                      |
|                       |          |           |                      |
|                       |          | REGULAR   |                      |
|                       |          |           |                      |
|                       |          | PRO       |                      |
|                       |          | BATIONARY |                      |
|                       |          |           |                      |
|                       |          | INTERIM   |                      |
|                       |          | REPORT    |                      |
|                       |          | [(State   |                      |
|                       |          | Re        |                      |
|                       |          | ason)]{.u |                      |
|                       |          | nderline} |                      |
|                       |          |           |                      |
|                       |          |           |                      |
|                       |          | OTHER     |                      |
|                       |          | [(State   |                      |
|                       |          | Re        |                      |
|                       |          | ason)]{.u |                      |
|                       |          | nderline} |                      |
|                       |          |           |                      |
+-----------------------+----------+-----------+----------------------+
| **4**. **THIS REPORT  |          |           |                      |
| COVERS THE PERIOD     |          |           |                      |
| FROM:**       **TO:** |          |           |                      |
|                       |          |           |                      |
+-----------------------+----------+-----------+----------------------+
| **5A. SUMMARY OF      |          |           |                      |
| DUTIES (WORK          |          |           |                      |
| REQUIREMENTS          |          |           |                      |
| STATEMENT)**          |          |           |                      |
|                       |          |           |                      |
|                       |          |           |                      |
+-----------------------+----------+-----------+----------------------+
| **5B. LIST SPECIFIC   |          |           |                      |
| GOALS AND OBJECTIVES  |          |           |                      |
| (FOR THE RATING       |          |           |                      |
| PERIOD)**             |          |           |                      |
|                       |          |           |                      |
|                       |          |           |                      |
+-----------------------+----------+-----------+----------------------+
| **6. SIGNATURE OF     | **7.     |           | **8. SIGNATURE OF    |
| RATED EMPLOYEE        | S        |           | REVIEWING OFFICIAL   |
| (DATE)**              | IGNATURE |           | (DATE)**             |
|                       | OF       |           |                      |
| ~(INDICATES\ WO       | RATING   |           | ~(CERTIFIES\ APPROV  |
| RK\ PLAN\ DISCUSSED\  | OFFICIAL |           | AL\ OF\ WORK\ PLAN)~ |
| AND\ COPY\ RECEIVED)~ | (DATE)** |           |                      |
|                       |          |           |                      |
|                       | ~(CERTI  |           |                      |
|                       | FIES\ WO |           |                      |
|                       | RK\ PLAN |           |                      |
|                       | \ DISCUS |           |                      |
|                       | SED\ WIT |           |                      |
|                       | H\ EMPLO |           |                      |
|                       | YEE\ AT\ |           |                      |
|                       |  BEGINNI |           |                      |
|                       | NG\ OF\  |           |                      |
|                       | RATING\  |           |                      |
|                       | PERIOD)~ |           |                      |
+-----------------------+----------+-----------+----------------------+

FORM JF-50 (12/95) Page 1

+-------------+---+----------+-----+---+---------+---------+---------+
| ## EVA      |   |          |     |   |         |         |         |
| LUATION OF  |   |          |     |   |         |         |         |
| PERFORMANCE |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| ### 9A.     |   |          |     |   |         |         |         |
| TO BE COMPL |   |          |     |   |         |         |         |
| ETED FOR AL |   |          |     |   |         |         |         |
| L EMPLOYEES |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| PERFORMANCE | N | UNSATI   | NE  |   | FULLY   | COMM    | OUTS    |
| FACTOR      | / | SFACTORY | EDS |   | SUC     | ENDABLE | TANDING |
|             | A |          | IM  |   | CESSFUL |         |         |
|             |   |          | PRO |   |         |         |         |
|             |   |          | VEM |   |         |         |         |
|             |   |          | ENT |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| De          |   |          |     |   |         |         |         |
| pendability |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| Job         |   |          |     |   |         |         |         |
| Knowledge   |   |          |     |   |         |         |         |
| and Skills  |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| Initiative  |   |          |     |   |         |         |         |
| and         |   |          |     |   |         |         |         |
| Reso        |   |          |     |   |         |         |         |
| urcefulness |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| Judgement   |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| Oral        |   |          |     |   |         |         |         |
| Co          |   |          |     |   |         |         |         |
| mmunication |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| Written     |   |          |     |   |         |         |         |
| Co          |   |          |     |   |         |         |         |
| mmunication |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| A           |   |          |     |   |         |         |         |
| daptability |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| D           |   |          |     |   |         |         |         |
| ecisiveness |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| In          |   |          |     |   |         |         |         |
| terpersonal |   |          |     |   |         |         |         |
| Re          |   |          |     |   |         |         |         |
| lationships |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| Supervisory |   |          |     |   |         |         |         |
| Skills      |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| **9B.       |   |          |     |   |         |         |         |
| RATING      |   |          |     |   |         |         |         |
| OFFICER'S   |   |          |     |   |         |         |         |
| SUPPORTING  |   |          |     |   |         |         |         |
| NARRATIVE   |   |          |     |   |         |         |         |
| EV          |   |          |     |   |         |         |         |
| ALUATION:** |   |          |     |   |         |         |         |
|             |   |          |     |   |         |         |         |
|             |   |          |     |   |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+
| JF-50       |   |          |     | P |         |         |         |
| (12/95)     |   |          |     | a |         |         |         |
|             |   |          |     | g |         |         |         |
|             |   |          |     | e |         |         |         |
|             |   |          |     | 2 |         |         |         |
+-------------+---+----------+-----+---+---------+---------+---------+

+------------------------+---------+----------+-----------------------+
| **10. RECOMMENDED      |         |          |                       |
| TRAINING (Optional)**  |         |          |                       |
|                        |         |          |                       |
|                        |         |          |                       |
+------------------------+---------+----------+-----------------------+
| **11. EMPLOYEE'S       |         |          |                       |
| STATEMENT (Comment on  |         |          |                       |
| your performance,      |         |          |                       |
| career goals, or other |         |          |                       |
| portions of this       |         |          |                       |
| report.) (Optional)**  |         |          |                       |
|                        |         |          |                       |
|                        |         |          |                       |
+------------------------+---------+----------+-----------------------+
| **12. REVIEWING        |         |          |                       |
| OFFICIAL'S STATEMENT   |         |          |                       |
| (Optional)**           |         |          |                       |
|                        |         |          |                       |
|                        |         |          |                       |
+------------------------+---------+----------+-----------------------+
| **13. SUMMARY RATING   |         |          |                       |
| [(Check appropriate    |         |          |                       |
| box):]{.underline}**   |         |          |                       |
|                        |         |          |                       |
| UNSATISFACTORY NEEDS   |         |          |                       |
| IMPROVEMENT FULLY      |         |          |                       |
| SUCCESSFUL COMMENDABLE |         |          |                       |
| OUTSTANDING            |         |          |                       |
+------------------------+---------+----------+-----------------------+
| **14. SIGNATURE OF     | 1       |          | **16. SIGNATURE OF    |
| RATED EMPLOYEE**       | 5. **SI |          | REVIEWING OFFICIAL    |
|                        | GNATURE |          | (DATE)**              |
| **(DATE)**             |     OF  |          |                       |
|                        |         |          |                       |
| **(INDICATES RATING    |  RATING |          |                       |
| DISCUSSED AND COPY     |         |          |                       |
| RECEIVED)**            | OFICIAL |          |                       |
|                        |     (   |          |                       |
|                        | DATE)** |          |                       |
|                        |         |          |                       |
|                        | **(IN   |          |                       |
|                        | DICATES |          |                       |
|                        | RATING  |          |                       |
|                        | DI      |          |                       |
|                        | SCUSSED |          |                       |
|                        | WITH    |          |                       |
|                        | EMPL    |          |                       |
|                        | OYEE)** |          |                       |
+------------------------+---------+----------+-----------------------+
| JF-50 (12/95)          |         | Page 3   |                       |
+------------------------+---------+----------+-----------------------+

+-----------------------------------+-----------------------------------+
| CERTIFICATIONS                    |                                   |
|                                   |                                   |
| The rating official is            |                                   |
| responsible for following         |                                   |
| certifications as appropriate.    |                                   |
+-----------------------------------+-----------------------------------+
| **17. WITHIN-GRADE STEP INCREASE  | 18. **POSITION DESCRIPTION        |
| CERTIFICATION:**                  |     CERTIFICATION (LEPCH          |
|                                   |     SEC.IV.C.3):**                |
| The rated employee is performing  |                                   |
| at the Fully Successful level     | I have reviewed the rated         |
|                                   | employee's position description   |
| or above, and should be granted   | and                               |
| the next Within-Grade Step        |                                   |
| Increase                          | certify that it is current and    |
|                                   | accurate.                         |
| when eligible.                    |                                   |
|                                   | YES NO                            |
| YES NO N/A                        |                                   |
|                                   | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\     |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\     | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | \_\                               |
| \_\                               | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   | *(Signature of Rating Official)   |
| *(Signature of Rating Official)   | (Date)*                           |
| (Date)*                           |                                   |
+-----------------------------------+-----------------------------------+
| **19. TRAINEE CERTIFICATION:**    | **20. PROBATIONARY PERIOD         |
|                                   | CERTIFICATION (FSNPAH SEC. 8.8)** |
| Employee has demonstrated the     |                                   |
| ability to perform the            | The rated employee's performance  |
| responsibilities assigned at the  | is at a level acceptable for      |
| next level of the career ladder   |                                   |
| and should be promoted when       | retention in the Service (at      |
| eligible (must have received a    | least fully Successful).          |
| summary rating of Fully           |                                   |
| Successful or higher).            | YES NO N/A                        |
|                                   |                                   |
| YES NO N/A                        | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\     |
|                                   | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\     | \_\                               |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\                               |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | *(Signature of Rating Official)   |
|                                   | (Date)*                           |
| *(Signature of Rating Official)   |                                   |
| (Date)*                           |                                   |
+-----------------------------------+-----------------------------------+
| **JUSTIFICATION FOR ANY BOX       |                                   |
| MARKED "NO"**                     |                                   |
|                                   |                                   |
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| JF-50 (12/95)                     | Page 4                            |
+-----------------------------------+-----------------------------------+

COMPLETING JF-50

[PAGE 1]{.underline}

**BLOCK 1**: Self-explanatory. \*

**BLOCK 2**: Enter the employee's name, **surname first. \***

**BLOCK 3:** Check the appropriate box. Interim reports are required
covering time periods of less than one year but not less than 120 days
when: employee is in trainee position and should be advanced to next
higher grade; rating officer departs; probationary certification is
required; rated employee departs; duties and responsibilities of the
rated employee change; the rated employee is promoted; a within-grade
step increase decision is inconsistent with the rated employee's last
performance rating or the employee's level of performance falls below
the Needs Improvement level. \*\*

**BLOCK 4:** Self-explanatory. \* and \*\*

**BLOCK 5A:** Summarize the major work requirements during the
performance period. Describe at least 2 requirements and no more than 5.
Do not exceed space provided. \*

**BLOCK 5B:** List specific goals for the current performance period
other than those ongoing duties listed in 5A.

**BLOCK 6:** Employee's signature indicates that the rating official has
discussed the work plan and provided a copy to the rated employee. \*

**BLOCK 7:** Rating official's signature certifies that the work plan
was discussed with the rated employee and a copy was provided to the
rated employee. \*

**BLOCK 8:** reviewing official's (rating official's supervisor)
signature indicates review and approval of the work plan. \*

# [PAGE 2]{.underline}

**BLOCK 9A:** Self-explanatory. \*

**BLOCK 9B:** Describe the employee's performance throughout the period
covered in this report based on the results achieved in relation to the
established duties, goals and objectives under 5A and 5B. Comments
should be related to how the performance factors directly influenced the
employees' meeting, exceeding or failing to meet the established duties,
goals, and objectives. For any performance factor marked "Needs
Improvement," the rater must describe the identified area and establish
a time frame for improvement. Additional pages may be used.

# [PAGE 3]{.underline}

**BLOCK 10:** Rating official may recommend various types of training
for rated employee's career development.

**BLOCK 11:** This section is for use by the rated employee only. \*\*

**BLOCK 12:** This block is provided for the narrative statement of the
reviewing official. Optional, but strongly recommended. \*\*

**BLOCK 13:** To be completed by the rating official upon completion of
the narrative description in Block 9B. the overall rating should be
consistent with the majority of performance factors marked in Block 9A.
\*\*

**BLOCK 14:** Signature of the rated employee indicates that the rating
has been discussed and a copy has been received. Rated employee may add
comments in Block No. 11, page 3.\*\*

**BLOCK 15:** Signature and date to be completed by rating official
indicating that the performance appraisal has been discussed with
employee and that a copy was provided to the employee. \*\*

**BLOCK 16:** Signature of the reviewing official indicated concurrence
with the rating level assigned if no comments in Block 12. The rating
official should be an American officer when staffing permits. \*\*

# [PAGE 4]{.underline}

**BLOCK 17:** To be singed and dated by the rating official upon
completion of the rating certifying that the rated employee should /
should not be granted the next within-grade step increase which becomes
due during the following annual appraisal cycle. A summary rating of
needs improvement may defer a within grade step increase to an employee
until performance has been determined to be fully successful (according
to policy established at Post). \*\*

**BLOCK 18:** To be signed and dated by the rating official certifying
accuracy of the current position description of record. When the rating
official does not certify affirmatively, he or she will prepare and
provide a revised position description to the Personnel Officer with 30
days of the rating. \*\*

**BLOCK 19:** To be signed and dated by the rating official certifying
employees in training positions should/ should not be promoted to the
next higher grade when time-in-grade requirements are met. \*\*

**BLOCK 20:** To be signed, dated, and the appropriate box checked by
the rating official certifying a probationary employee's performance is
/ is not at an acceptable level of competence for retention in the
service (a Fully Successful or higher overall rating is required). \*\*

\* To be completed within the first 30 days of the rating period.

\*\* To be completed at the end of the rating period.

**INSTRUCTIONS FOR PREPARATION OF PERFORMANCE EVALUTION REORT**

**FOREIGN SERVICE NATIONAL EMPLOYEES (JF-50)**

# [PAGE 1]{.underline}

**BLOCK 1**: Self-explanatory. \*

**BLOCK 2**: Enter the employee's name, **surname first. \***

**BLOCK 3:** Check the appropriate box. Interim reports are required
covering time periods of less than one year but not less than 120 days
when: employee is in trainee position and should be advanced to next
higher grade; rating officer departs; probationary certification is
required; rated employee departs; duties and responsibilities of the
rated employee change; the rated employee is promoted; a within-grade
step increase decision is inconsistent with the rated employee's last
performance rating or the employee's level of performance falls below
the Marginal level. \*\*

**BLOCK 4:** Self-explanatory. \* and \*\*

**BLOCK 5A:** Summarize the major work requirements during the
performance period. Describe at least 2 requirements and no more than 5.
Do not exceed space provided. \*

**BLOCK 5B:** List specific goals for the current performance period
other than those ongoing duties listed in 5A. This block is mandatory
for FSN-09 and above.

**BLOCK 6:** Employee's signature indicates that the rating official has
discussed the work plan and provided a copy to the rated employee. \*

**BLOCK 7:** Rating official's signature certifies that the work plan
was discussed with the rated employee and a copy was provided to the
rated employee. \*

**BLOCK 8:** reviewing official's (rating official's supervisor)
signature indicates review and approval of the work plan. \*

**BLOCK 9:** To be completed by the Rating official upon completion of
the narrative description in Block 12.

# [PAGE 2]{.underline}

**BLOCK 10:** Enter employee's name, **surname first. \***

**BLOCK 11:** Self-explanatory. \*

**BLOCK 12A:** Self-explanatory. \*

**BLOCK 12B:** For any summary rating other the Fully Successful, and
for all employees FSN-09 and above, briefly describe accomplishments
during the rating period. Accomplishments must be directly related to
the duties and goals defined in Block 5. Additional pages may be used.
Raters may include areas of improvements as appropriate.

#### PAGE 3

**BLOCK 13:** Enter the employee's name, **surname first. \***

**BLOCK 14**: Self-explanatory. \*

**BLOCK 15:** This block is provided for the narrative statement of the
reviewing official. Optional, but strongly recommended. \*\*

**BLOCK 16:** This section is for use by the rated employee only. \*\*

**BLOCK 17:** Signature of the rated employee indicates that the rating
has been discussed and a copy has been received. Rated employee may add
comments in Block No. 16, page 5.\*\*

**BLOCK 18:** Signature and date to be completed by rating official
indicating that the performance appraisal has been discussed with
employee and that a copy was provided to the employee. \*\*

**BLOCK 19:** Signature of the reviewing official indicated concurrence
with the rating level assigned if no comments in Block 15. The rating
official should be an American officer when staffing permits. \*\*

# [PAGE 4]{.underline}

**BLOCK 20:** To be singed and dated by the rating official upon
completion of the rating certifying that the rated employee should /
should not be granted the next within-grade step increase which becomes
due during the following annual appraisal cycle. \*\*

**BLOCK 21:** To be signed and dated by the rating official certifying
accuracy of the current position description of record. When the rating
official does not certify affirmatively, he or she will prepare and
provide a revised position description to the Personnel Officer with 30
days of the rating. \*\*

**BLOCK 22:** To be signed and dated by the rating official certifying
employees in training positions should/ should not be promoted to the
next higher grade when time-in-grade requirements (3 FAM 952) are met.
\*\*

**BLOCK 23:** To be signed, dated, and the appropriate box checked by
the rating official certifying a probationary employee's performance is
/ is not at an acceptable level of competence for retention in the
service (a Fully Successful or higher overall rating is required). \*\*

\* To be completed within the first 30 days of the rating period.

\*\* To be completed at the end of the rating period.