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<strong>PENILAIAN PRESTASI KERJA<br />
PEGAWAI NEGERI SIPIL</strong></div>
<br>
<div align='right'><strong>JANGKA WAKTU PENILAIAN</strong><br />
01 Januari 2019 s/d 31 Desember 2019</strong></div>
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<tr>
<td><strong>1.</strong></td>
<td colspan='5'><strong>YANG DINILAI</strong></td>
</tr>
<tr>
<td></td>
<td>Nama</td>
<td colspan='4'> MUHAMAD ZULKAN, A.Md.</td>
</tr>
<tr>
<td></td>
<td>NIP.</td>
<td colspan='4'>19790806 201407 1 002</td>
</tr>
<tr>
<td></td>
<td>Pangkat/Gol. Ruang</td>
<td colspan='4'>Pengatur Muda Tingkat I (II/b)</td>
</tr>
<tr>
<td></td>
<td>Jabatan</td>
<td colspan='4'>Pengadministrasi Kependidikan</td>
</tr>
<tr>
<td></td>
<td>Unit Kerja</td>
<td colspan='4'>DINAS PENDIDIKAN - CABANG DINAS PENDIDIKAN WILAYAH BLITAR - UPT
SATUAN PENDIDIKAN - KABUPATEN BLITAR - SMAN 1 KESAMBEN - FUNGSIONAL</td>
</tr>
<tr>
<td><strong>2.</strong></td>
<td colspan='5'><strong>PEJABAT PENILAI </strong></td>
</tr>
<tr>
<td></td>
<td>Nama</td>
<td colspan='4'> EDY SASMITO S.S.,M.Pd.</td>
</tr>
<tr>
<td></td>
<td>NIP.</td>
<td colspan='4'>19720726 200501 1 013</td>
</tr>
<tr>
<td></td>
<td>Pangkat/Gol. Ruang</td>
<td colspan='4'>Pembina (IV/a)</td>
</tr>
<tr>
<td></td>
<td>Jabatan</td>
<td colspan='4'>Guru Ahli Madya</td>
</tr>
<tr>
<td></td>
<td>Unit Kerja</td>
<td colspan='4'>DINAS PENDIDIKAN - CABANG DINAS PENDIDIKAN WILAYAH BLITAR - UPT
SATUAN PENDIDIKAN - KABUPATEN BLITAR - SMAN 1 KESAMBEN</td>
</tr>

<tr>
<td><strong>3.</strong></td>
<td colspan='5'><strong>ATASAN PEJABAT PENILAI </strong></td>
</tr>
<tr>
<td></td>
<td>Nama</td>
<td colspan='4'>Drs. TRISILO BUDI PRASETYO M.M.</td>
</tr>
<tr>
<td></td>
<td>NIP.</td>
<td colspan='4'>19651015 199302 1 002</td>
</tr>
<tr>
<td></td>
<td>Pangkat/Gol. Ruang</td>
<td colspan='4'>Pembina Tingkat I (IV/b)</td>
</tr>
<tr>
<td></td>
<td>Jabatan</td>
<td colspan='4'>Kepala Cabang Dinas Pada Cabang Dinas Pendidikan Wilayah
Blitar</td>
</tr>
<tr>
<td></td>
<td>Unit Kerja</td>
<td colspan='4'>DINAS PENDIDIKAN - CABANG DINAS PENDIDIKAN WILAYAH BLITAR</td>
</tr>

<tr>
<td><strong>4.</strong></td>
<td colspan='4'><strong>UNSUR YANG DINILAI</strong></td>
<td><div align='center'><strong>JUMLAH</strong></div></td>
</tr>
<tr><td></td>
<td><strong>Sasaran Kerja PNS (SKP)</strong></td><td
colspan='3'><center><strong>15950.33 x
60%</strong></center></td><td><center><strong>9570.2</strong></center></td>
</tr>
<tr>
<td></td>
<td><strong>Perilaku Kerja</strong></td>
<td>1. Orientasi Pelayanan</td>
<td><center>83</center></td>
<td><center>Baik</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>2. Integritas</td>
<td><center>83</center></td>
<td><center>Baik</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>3. Komitmen</td>
<td><center>83</center></td>
<td><center>Baik</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>4. Disiplin</td>
<td><center>83</center></td>
<td><center>Baik</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>5. Kerjasama</td>
<td><center>83</center></td>
<td><center>Baik</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>6. Kepemimpinan</td>
<td><center>-</center></td>
<td><center>-</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>7. Jumlah</td>
<td><center>415</center></td>
<td></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td>8. Nilai Rata-rata</td>
<td><center>83</center></td>
<td><center>Baik</center></td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td><p><strong>9. Nilai Perilaku Kerja</strong></td>
<td colspan='2'><center><strong>83 x 40%</strong></center></td>
<td><center><strong>33.2 </strong></center></td>
</tr>
<tr>
<td colspan='5'><div align='center'><strong>Nilai Prestasi
Kerja</strong></div></td>
<td><center><strong>9603.4 <br> Sangat Baik</strong></center></td>
</tr>

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<tr>
<td width='5'><strong>5.</strong></td>
<td colspan='5'><strong>KEBERATAN DARI PEGAWAI NEGERI SIPIL YANG DINILAI
(APABILA ADA)</strong>
<br>
<br>
<br>
<br>
<br>
<br>
<div align=right>Tanggal, ..................................</div>
</td>
</tr>
<tr>
<td width='5'><strong>6.</strong></td>
<td colspan='5' ><strong>TANGGAPAN PEJABAT PENILAI ATAS</strong>
<br>
<br>
<br>
<br>
<br>
<br>
<div align=right>Tanggal, ..................................</div>
</td>
</tr>
<tr>
<td width='5'><strong>7.</strong></td>
<td colspan='5' ><strong>KEPUTUSAN ATASAN PEJABAT</strong>
<br>
<br>
<br>
<br>
<br>
<br>
<div align=right>Tanggal, ..................................</div>
</td>
</tr>
<tr>
<td width='5'><strong>8.</strong></td>
<td colspan='5' ><strong>REKOMENDASI</strong> <br><br>
<br>
<br>
<br>
<br>
<br>
<br>
</td>
</tr>
<tr>
<td colspan='3'></td>
<td colspan='3' width='50%'><strong>9. DIBUAT TANGGAL, 31 Desember
2019</strong><br>
&nbsp;&nbsp;&nbsp;&nbsp;PEJABAT PENILAI
<br>
<br>
<br>
<br>
<br>
<br>
&nbsp;&nbsp;&nbsp;&nbsp;( EDY SASMITO S.S.,M.Pd. ) <br>
&nbsp;&nbsp;&nbsp;&nbsp;NIP. 19720726 200501 1 013
</td>
</tr>

<tr>
<td colspan='3'><strong>10. DITERIMA TANGGAL, 02 Januari 2020</strong><br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;PEGAWAI NEGERI SIPIL YANG DINILAI
<br>
<br>
<br>
<br>
<br>
<br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;( MUHAMAD ZULKAN, A.Md. ) <br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;NIP. 19790806 201407 1 002
</td>
<td colspan='3'></td>
</tr>

<tr>
<td colspan='3'</td>
<td colspan='3'><strong>11. DITERIMA TANGGAL, 03 Januari 2020</strong><br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;ATASAN PEJABAT YANG MENILAI
<br>
<br>
<br>
<br>
<br>
<br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(Drs. TRISILO BUDI PRASETYO M.M. ) <br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;NIP. 19651015 199302 1 002
</td>
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