Free Da 2166 9 1 Form
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NCO EVALUATION REPORT (SGT)
For use of this form, see AR
SEE PRIVACY ACT STATEMENT
IN AR
PART I
a.NAME (Last, First, Middle Initial)
b. SSN (or DOD ID No.)
c. RANK
d. DATE OF RANK
e. PMOSC
f. UNIT, ORG, STATION, ZIP CODE OR APO, MAJOR COMMAND
g. STATUS CODE
h. UIC
i. REASON FOR SUBMISSION
j. PERIOD COVERED
FROMTHRU
YEAR MONTH DAY |
YEAR MONTH DAY |
k.RATED MONTHS
l.NONRATED CODES
m. NO OF ENCLOSURES
n. RATED NCO'S EMAIL ADDRESS (.gov or .mil)
PART II
a1. NAME OF RATER (Last, First, Middle Initial)
a2. SSN (or DOD ID No.)
a3. RATER'S SIGNATURE
a4. DATE (YYYYMMDD)
a5. RANK |
PMOSC/BRANCH |
ORGANIZATION |
DUTY ASSIGNMENT
a6. RATER'S EMAIL ADDRESS (.gov or .mil)
b1. NAME OF SENIOR RATER (Last, First, Middle Initial)
b2. SSN (or DOD ID No.)
b3. SENIOR RATER'S SIGNATURE
b4. DATE (YYYYMMDD)
b5. RANK |
PMOSC/BRANCH |
ORGANIZATION |
DUTY ASSIGNMENT |
b6. SENIOR RATER'S EMAIL ADDRESS (.gov or .mil)
c1. SUPPLEMENTARY |
c2. NAME OF SUPPLEMENTARY REVIEWER |
c3. RANK |
PMOSC/ |
ORGANIZATION |
DUTY ASSIGNMENT |
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REVIEW REQUIRED? |
(Last, First, Middle Initial) |
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BRANCH |
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YES |
NO |
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c4. COMMENTS |
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c5. SUPPLEMENTARY REVIEWER'S SIGNATURE |
c6. DATE(YYYYMMDD) |
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c7. SUPPLEMENTARY REVIEWER'S EMAIL ADDRESS |
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ENCLOSED? |
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(.gov or .mil) |
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YES |
NO |
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RATED NCO: I understand my signature does not constitute agreement or disagreement with the assessments of the rater and senior rater. I further understand my signature verifies that the administrative data in Part I, the rating officials and counseling dates in Part II, the duty description in Part III, and the APFT and height/weight entries in Part IVa and IVb are correct. I have seen the completed report. I am aware of the appeals process of AR
d1. COUNSELING DATES INITIAL
LATER
LATER
LATER
d2. RATED NCO'S SIGNATURE
d3. DATE (YYYYMMDD)
PART III
a. PRINCIPAL DUTY TITLE
b. DUTY MOSC
c.DAILY DUTIES AND SCOPE (To include, as appropriate, people, equipment, facilities, and dollars)
d.AREAS OF SPECIAL EMPHASIS
e.APPOINTED DUTIES
PART IV
a. APFT Pass/Fail/Profile: |
Date: |
b. Height: |
Weight: |
Within Standard? |
(Comments required for "Failed" APFT, "No" APFT, or "Profile" when it precludes performance of duty, and "No" for Army Weight Standards.) Reset Item a. APFT/Pass/Fail/Profile
c.CHARACTER: (Include bullet comments addressing Rated NCO's performance as it relates to adherence to Army Values, Empathy, Warrior Ethos/Service Ethos, and Discipline. Fully supports SHARP, EO, and EEO.)
MET |
DID NOT MEET |
STANDARD |
STANDARD |
COMMENTS:
DA FORM |
Page 1 of 2 |
APD LC v1.00ES
RATED NCO'S NAME (Last, First, Middle Initial) |
SSN (or DOD ID No.) |
THRU DATE |
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PART IV
d. PRESENCE: (Military and professional |
COMMENTS: |
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bearing, Fitness, Confidence, Resilience.) |
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MET |
DID NOT MEET |
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STANDARD |
STANDARD |
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e. INTELLECT: (Mental agility, Sound judgment, COMMENTS: |
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Innovation, Interpersonal tact, Expertise.) |
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MET |
DID NOT MEET |
STANDARD |
STANDARD |
f. LEADS: (Leads others, Builds trust, Extends COMMENTS: |
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influence beyond the chain of command, Leads by |
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example Communicates.) |
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MET |
DID NOT MEET |
STANDARD |
STANDARD |
g. DEVELOPS: (Creates a positive command/ COMMENTS: |
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workplace environment, Fosters esprit de corps, |
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Prepares self, Develops others, Stewards the |
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profession.) |
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MET |
DID NOT MEET |
STANDARD |
STANDARD |
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h. ACHIEVES: (Gets results.) |
COMMENTS: |
MET |
DID NOT MEET |
STANDARD |
STANDARD |
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RATER OVERALL PERFORMANCE |
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i. I currently rate |
NCOs in this grade. |
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COMMENTS: |
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PART V |
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a. Select one box representing Rated |
b. COMMENTS: |
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NCO’s potential compared to others in the |
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same grade whom you have rated in your |
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career. I currently senior rate |
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NCOs in this grade. |
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MOST QUALIFIED |
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HIGHLY QUALIFIED |
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QUALIFIED |
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NOT QUALIFIED |
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c. List two successive assignments and one broadening assignment |
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Successive Assignment: |
1) |
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2) |
Broadening Assignment: |
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DA FORM |
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Page 2 of 2 |
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APD PE v1.00ES |
Common mistakes
Filling out the DA 2166-9-1 form can be a daunting task, and many individuals make mistakes that can affect the evaluation process. One common error occurs when people forget to double-check their personal information. This includes their name, Social Security Number (SSN), and rank. Any discrepancies in this vital information can lead to delays or complications in processing the evaluation. It’s crucial to ensure that these details are accurate and match official records.
Another frequent mistake is neglecting to provide a complete duty description in Part III. Many individuals either leave this section blank or provide vague descriptions. This is problematic because the duty description is essential for understanding the NCO's role and contributions. Clear and detailed descriptions help evaluators assess performance accurately. It’s important to include specifics about daily duties, areas of special emphasis, and any appointed duties.
People often overlook the importance of the counseling dates in Part II. These dates are not merely formalities; they serve as a record of when the rated NCO received feedback on their performance. Missing or incorrect counseling dates can lead to misunderstandings about the evaluation process. It’s advisable to ensure that all counseling dates are filled in correctly and reflect the actual dates of discussions.
Another mistake involves the performance evaluation section, particularly in providing comments. Some individuals fail to offer meaningful comments or provide generic statements that do not accurately reflect the rated NCO's performance. Evaluators rely on these comments to understand the individual’s strengths and areas for improvement. Thoughtful, specific feedback is essential for a fair assessment.
Finally, many people forget to obtain the necessary signatures from the rater and senior rater before submission. The signatures not only authenticate the evaluation but also indicate that all parties have reviewed the contents. Without these signatures, the form may be considered incomplete, resulting in delays or rejections. Always remember to gather all required signatures to ensure a smooth evaluation process.
Dos and Don'ts
When filling out the DA 2166-9-1 form, keep the following tips in mind:
- Do double-check all personal information for accuracy, including names and SSN.
- Do ensure all required signatures are obtained before submission.
- Do provide clear and concise descriptions in the duty description section.
- Do follow the guidelines for the performance evaluation carefully.
- Do keep a copy of the completed form for your records.
- Don't leave any required fields blank; this could delay processing.
- Don't use abbreviations or jargon that may confuse the reader.
- Don't rush through the evaluation; take your time to provide thoughtful feedback.
- Don't forget to review the privacy statement associated with the form.
- Don't submit the form without confirming all information is current and correct.
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DA Form 4856 (Developmental Counseling Form): This document is used for counseling sessions. While it is not an evaluation report, it serves a similar purpose in documenting performance and providing feedback.
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DA Form 7500 (Noncommissioned Officer Professional Development Guide): This guide outlines the requirements for NCO professional development. It complements the evaluation process by helping NCOs understand expectations and career progression.
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DA Form 2446 (Request for Evaluation): This form is used to initiate an evaluation for personnel. It helps in gathering necessary information before completing the formal evaluation, similar to the DA 2166-9-1's administrative data section.