contoh-skp-pns.xlsx
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KANTOR REGIONAL IIIBADAN KEPEGAWAIAN NEGARA
MENU SASARAN KERJAPEGAWAI NEGERI SIPIL
1. DATA SASARAN KERJA PEGAWAI
3. FORMULIR SKP
2. COVER
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DATA SASARAN KERJA PEGAWAI
1 YANG DINILAI
a. Nama : Ellya S!
". NIP :#. Pa$%&a'(G)l.R*a$% :
+. Ja"a'a$ :
,. U$-' K,/a :
2 PEJA0AT PENILAI
a. Nama : Da. S-
". NIP :
#. Pa$%&a'(G)l.R*a$% :
+. Ja"a'a$ :
,. U$-' K,/a :
3 ATASAN PEJA0AT PENILAI
a. Nama :
". NIP :
#. Pa$%&a'(G)l.R*a$% :+. Ja"a'a$ :
,. U$-' K,/a :
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PENILAIAN PRESTASI KERJA
PEGAWAI NEGERI SIPIL
Jangka Waktu Penilaian Jaanuari s! Dese"#er $%&'
Nama P,%aa- : Ell(a) S*
NIP : Pa$%&a' G)l)$%a$ R*a :
Ja"a'a$ :
U$-' K,/a :
BADAN KEPEGAWAIAN DAERA*
TA*UN $%&'
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+ORMULIR SASARAN KERJA
PEGAWAI NEGERI SIPIL
NO I, PEJABAT PENILAI NO II, PEGAWAI NEGERI SIPIL -ANG DINILAI
1 Nama Da. S- 1 Nama Ellya S!
2 NIP 2 NIP
3 Pa$%&a'(G)l.R*a$% 3 Pa$%&a'(G)l.R*a$%
Ja"a'a$ Ja"a'a$
4 U$-' K,/a 4 U$-' K,/a
NO III, KEGIATAN TUGAS JABATAN AK TARGET
KUANTOUTPUT KUALMUTU WAKTU BIA-A
1
2
3
4
5
6
7
8
1
11
12
13
1
14
15
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PENILAIAN CAPAIAN SASARAN KERJA
PEGAWAI NEGERI SIPIL
Ja$%&a Wa&'* P,$-la-a$
Jaa$*a- =(+ D,=,m", 21
NO I, KEGIATAN TUGAS TAMBA*AN AK TARGET AK K*a$'( O*'*' Wa&'* 0-aya
& $ . ' / 0 1 2 3
1 >
2 >
3 >
>
4 >
5 >
6 >
7 > 8 >
1 >
11 >
12 >
13 >
1 >
14 >
15 >
16 >
17 >
18 >
2 >
K*al(M*'*
K*a$'(O*'*'
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II, TUGAS TAMBA*AN DAN KREATI4ITAS 5
1 6tugas ta"#a7an8
6tugas ta"#a7an8
2 6kreati9tas8
6kreati9tas8
Nilai Ca:aian SKP
0a$+
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&. &'
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PENG*I
TUNGAN
NILAI
CAPAIANSKP
BACK
TOMENUUTA
MA
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;DI4%<
;DI4%<
", 21
la-
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BUKU CATATAN PENILAIAN PERILAKU PNS
Nama : Ellya S!
NIP :
N) Ta$%%al Ua-a$
1 2 3
1 P,$-la-a$ SKP =ama- +,$%a$ a&- D,=,m", 21 B
??? =,+a$%&a$ ,$-la-a$ ,-la&* &,/a$ya a+ala
=,"a%a- ",-&*' :
O-,$'a=- P,laya$a$ B 0**&
I$',%-'a= B 0**&
K)m-'m,$ B 0**&
D-=-l-$ B 0**&
K,/a=ama B 0**& Da. S-
K,,m-m-$a$ B 0**&
J*mla B
N-la- Ra'a>a'a B . 0**&
Nama(NIP +a$ Paa<P,/a"a' P,$-la-
Jaa$*a- =(+D,=,m",
21
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Ta$%%al ................................
5. TANGGAPAN PEJA0AT PENILAI ATAS KE0ERATAN
Ta$%%al ................................
6. KEPUTUSAN ATASAN PEJA0AT PENILAI ATAS
KE0ERATAN
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Ta$%%al ................................
7. REKOMENDASI
8. DI0UAT TANGGAL
PEJA0AT PENILAI
Da. S-
1. DITERIMA TANGGAL
PEGAWAI NEGERI SIPIL YANGDINILAI
Ellya S!
11. DITERIMA TANGGAL
ATASAN PEJA0AT YANG MENILAI
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