[104-10193-10069.pdf — page 52]
# SECRET# FITNESS REPORT (Part I) PERFORMANCEINSTRUCTIONSFOR THE ADMINISTRATIVE OFFICER: Consult current instructors for completing this report.FOR THE SUPERVISOR: This report is designed to help you express your evaluation of your subordinate and to transmit this evaluation to your supervisor and senior officials. Organization policy requires that you inform the subordinate where he stands with you. Completion of this report can help you prepare for a discussion with him of his strengths and weaknesses. It is also organization policy that you show Part I of this report to the employee except under conditions specified in Regulation 20:170. It is recommended that you read the entire form before completing any question. If this is the initial report on the employee, it must be completed and forwarded to the Office of Personnel no later than 30 days after the date indicated in item 8. of Section A below.SECTION A.1. NAMEBurkey William P., Jr. 22 Oct 1900 N. OC5. OFFICE/DIVISION/BRANCH OF ASSIGNMENT 6. OFFICIAL POSITION TITLEOperations/Contact/New Orleans Office IO (Contact)7. GRADE 8. DATE REPORT. DUE IN OP 9. PERIOD COVERED BY THIS REPORT (Inclusive dates)GS-15 9 September 1956 9/9/55 - 9/8/5610. TYPE OF REPORT(Check one) - ANNUALSECTION B.1. FOR THE RATER: THIS REPORT HAS [X] HAS NOT BEEN SHOWN TO THE INDIVIDUAL RATED. IF NOT SHOWN, EXPLAIN WHYSubject is stationed in Louisiana.A. CHECK (X) APPROPRIATE STATEMENTS:[X] THIS REPORT REFLECTS MY OWN OPINIONS OF THIS INDIVIDUAL.THIS REPORT REFLECTS THE COMBINED OPINIONS OF MYSELF AND PREVIOUS SUPERVISORS.I HAVE DISCUSSED WITH THIS EMPLOYEE HIS STRENGTHS AND WEAKNESSES SO THAT HE KNOWS WHERE HE STANDS.B. THIS DATE7 Nov 56C. TYPED OR PRINTED NAME AND SIGNATURE OF SUPERVISOR D. SUPERVISOR'S OFFICIAL TITLES. M. ASHCRAFT Chief, Contact Division2. FOR THE REVIEWING OFFICIAL: RECORD ANY SUBSTANTIAL DIFFERENCE OF OPINION WITH THE SUPERVISOR, OR ANY OTHER INFORMATION, WHICH WILL LEAD TO A BETTER UNDERSTANDING OF THIS REPORT.![Signature]Posted for. ContBY gw DATE11-13-5![Signature]CONTINUED ON ATTACHED SHEETI certify that any substantial difference of opinion with the supervisor is reflected in the above section.A. THIS DATE![Signature]B. TYPED OR PRINTED NAME AND SIGNATURE OF REVIEWING C. OFFICIAL TITLE OF REVIEWING OFFICIALGEORGE G. CAREY Assistant Director for OperationsSECTION C.1. RATING ON GENERAL PERFORMANCE OF DUTIESDIRECTIONS: Consider ONLY the productivity and effectiveness with which the individual being rated has performed his duties during the rating period. Compare him (her) with others doing similar work at a similar level of responsibility. Factors other than productivity will be taken into account later in Section D.5INSERT RATING NUMBER1 - DOES NOT PERFORM DUTIES ADEQUATELY HE IS INCOMPETENT.2 - BARELY ADEQUATE IN PERFORMANCE. ALTHOUGH HE HAS HAD SPECIFIC GUIDANCE OR TRAINING, HE OFTEN FAILS TO CARRY OUT RESPONSIBILITIES.3 - PERFORMS MOST OF HIS DUTIES ACCEPTABLY. OCCASIONALLY REVEALS SOME AREA OF WEAKNESS.4 - PERFORMS DUTIES IN A COMPETENT, EFFECTIVE MANNER.5 - A FINE PERFORMANCE: CARRIES OUT MANY OF HIS RESPONSIBILITIES EXCEPTIONALLY WELL.6 - PERFORMS HIS DUTIES IN SUCH AN OUTSTANDING MANNER THAT HE IS EQUALLED BY FEW OTHER PERSONS KNOWN TO THE SUPERVISOR.COMMENTS:FORM NO. 45 (Part 1)1 NOV 55REPLACES PREVIOUS EDITIONS OF FORMS 45 AND 45A WHICH ARE OBSOLETE.SECRETPerformance(4)