[104-10195-10002.pdf — page 126]
# SECRET(When Filed In)EMPLOYEE SERIAL NUMBERFITNESS REPORT## GENERAL1. NAME:2. DATE OF BIRTH: 20 Jan 19243. SEX: M4. GRADE: 03-145. SERVICE DESIGNATION & OFFICIAL POSITION TITLE: DI6. OFF/DIV/BR OF ASSIGNMENT: FA/Tokyo Sta/SRCAREER STAFF STATUS7. TYPE OF REPORT:NOT ELIGIBLEMEMBERDEFERREDINITIALREASSIGNMENT/SUPERVISORPENDINGDECLINEDDENIEDANNUALREASSIGNMENT/EMPLOYEESPECIAL (Specify)10. DATE REPORT DUE IN O.P.11. REPORTING PERIOD: 1 Apr 58-30 June 60## SECTION B EVALUATION OF PERFORMANCE OF SPECIFIC DUTIESList up to six of the most important specific duties performed during the rating period. Insert rating number which best describes the manner in which employee performs EACH specific duty. Consider ONLY effectiveness in performance of that duty. All employees with supervisory responsibilities MUST be rated on their ability to supervise (indicate number of employees supervised).1 - Unsatisfactory 2 - Barely adequate 3 - Acceptable 4 - Competent 5 - Excellent 6 - Superior 7 - OutstandingSPECIFIC DUTY NO. 1RATING NO.SPECIFIC DUTY NO. 4RATING NO.Chief, Soviet Branch, responsible for activities of 26 staff and 6 contract employeesCase officer6/8SPECIFIC DUTY NO. 2RATING NO.SPECIFIC DUTY NO. 5RATING NO.Responsible for station SR planning, budgeting, and operating activities6SPECIFIC DUTY NO. 3RATING NO.SPECIFIC DUTY NO. 6RATING NO.Representing the station at varied levels in all SR matters6## SECTION C EVALUATION OF OVERALL PERFORMANCE IN CURRENT POSITIONTake into account everything about the employee which influences his effectiveness in his current position - performance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal traits or habits, particular limitations or talents. Based on your knowledge of employee's overall performance during the rating period, place the rating number in the box corresponding to the statement which most accurately reflects his level of performance.1 - Performance in many important respects fails to meet requirements.2 - Performance meets most requirements but is deficient in one or more important respects.3 - Performance clearly meets basic requirements.4 - Performance clearly exceeds basic requirements.5 - Performance in every important respect is superior.6 - Performance in every respect is outstanding.RATING NO.5## SECTION D DESCRIPTION OF THE EMPLOYEEIn the rating boxes below, check (X) the degree to which each characteristic applies to the employee.1 - Least possible degree 2 - Limited degree 3 - Normal degree 4 - Above average degree 5 - Outstanding degree| CHARACTERISTICS                                                 | NOT APPLICABLE | NOT OBSERVED | 1   | 2   | 3   | 4   | 5   || --------------------------------------------------------------- | -------------- | ------------ | --- | --- | --- | --- | --- || GETS THINGS DONE                                                |                |              |     |     |     | X   |     || RESOURCEFUL                                                     |                |              |     |     |     |     | X   || ACCEPTS RESPONSIBILITIES                                        |                |              |     |     |     |     | X   || CAN MAKE DECISIONS ON HIS OWN WHEN NEED ARISES                  |                |              |     |     |     |     | X   || DOES HIS JOB WITHOUT STRONG SUPPORT                             |                |              |     |     |     |     | X   || FACILITATES SMOOTH OPERATION OF HIS OFFICE                      |                |              |     |     |     |     | X   || WRITES EFFECTIVELY                                              |                |              |     |     |     |     | X   || SECURITY CONSCIOUS                                              |                |              |     |     |     | X   |     || THINKS CLEARLY                                                  |                |              |     |     |     |     | X   || DISCIPLINE IN ORIGINATING, MAINTAINING AND DISPOSING OF RECORDS |                |              |     |     | X   |     |     || OTHER (Specify):                                                |                |              |     |     |     |     |     |FORM 8-58 45 OBSOLETE PREVIOUS EDITIONS.SEE SECTION "E" ON REVERSE SIDESECRET(14)