Smart Legal Forms

Smart Legal Forms

Homepage Free Da 2166 9 1 Form

Form Preview Example

HQDA#:

Attachments Menu

NCO EVALUATION REPORT (SGT)

For use of this form, see AR 623-­3 and DA PAM 623-­3 the proponent agency is DCS, G-­1.

SEE PRIVACY ACT STATEMENT

IN AR 623-­3

PART I ADMINISTRATIVE DATA

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 AUTHENTICATION

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

REVIEW REQUIRED?

(Last, First, Middle Initial)

 

 

BRANCH

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c4. COMMENTS

 

c5. SUPPLEMENTARY REVIEWER'S SIGNATURE

c6. DATE(YYYYMMDD)

 

c7. SUPPLEMENTARY REVIEWER'S EMAIL ADDRESS

ENCLOSED?

 

 

 

 

 

 

(.gov or .mil)

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 623-­3.

d1. COUNSELING DATES INITIAL

LATER

LATER

LATER

d2. RATED NCO'S SIGNATURE

d3. DATE (YYYYMMDD)

PART III DUTY DESCRIPTION (Rater)

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 PERFORMANCE EVALUATION, PROFESSIONALISM, ATTRIBUTES, AND COMPETENCIES (Rater)

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 2166-­9-­1, NOV 2015

Page 1 of 2

APD LC v1.00ES

RATED NCO'S NAME (Last, First, Middle Initial)

SSN (or DOD ID No.)

THRU DATE

 

 

 

PART IV PERFORMANCE EVALUATION, PROFESSIONALISM, ATTRIBUTES, AND COMPETENCIES (Rater)

d. PRESENCE: (Military and professional

COMMENTS:

bearing, Fitness, Confidence, Resilience.)

 

MET

DID NOT MEET

 

STANDARD

STANDARD

 

e. INTELLECT: (Mental agility, Sound judgment, COMMENTS:

Innovation, Interpersonal tact, Expertise.)

MET

DID NOT MEET

STANDARD

STANDARD

f. LEADS: (Leads others, Builds trust, Extends COMMENTS:

influence beyond the chain of command, Leads by

example Communicates.)

 

MET

DID NOT MEET

STANDARD

STANDARD

g. DEVELOPS: (Creates a positive command/ COMMENTS:

workplace environment, Fosters esprit de corps,

Prepares self, Develops others, Stewards the

profession.)

 

MET

DID NOT MEET

STANDARD

STANDARD

 

 

h. ACHIEVES: (Gets results.)

COMMENTS:

MET

DID NOT MEET

STANDARD

STANDARD

 

 

 

 

 

 

RATER OVERALL PERFORMANCE

 

i. I currently rate

NCOs in this grade.

 

COMMENTS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART V SENIOR RATER OVERALL POTENTIAL

a. Select one box representing Rated

b. COMMENTS:

 

NCO’s potential compared to others in the

 

 

same grade whom you have rated in your

 

 

career. I currently senior rate

 

 

NCOs in this grade.

 

 

 

 

 

 

 

 

 

 

 

 

MOST QUALIFIED

 

 

 

 

 

 

HIGHLY QUALIFIED

 

 

QUALIFIED

 

 

 

 

 

 

NOT QUALIFIED

 

 

 

 

 

 

 

 

 

c. List two successive assignments and one broadening assignment (3-­5 years).

 

Successive Assignment:

1)

 

 

2)

Broadening Assignment:

 

 

 

DA FORM 2166-­9-­1, NOV 2015

 

Page 2 of 2

 

 

 

 

 

 

 

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.

Similar forms

  • DA Form 2166-9-2 (NCO Evaluation Report): This form evaluates NCOs at a higher rank than the SGT level. It covers similar areas of performance and potential but is tailored for more senior NCOs.

  • DA Form 1059 (Academic Evaluation Report): This document assesses soldiers' performance in academic courses. Like the DA 2166-9-1, it evaluates skills and competencies but focuses on educational achievements.

  • Durable Power of Attorney: This legal document ensures that a trusted individual can make decisions on your behalf if you become incapacitated, providing essential peace of mind and continuity in managing your affairs. For more information, visit TopTemplates.info.
  • DA Form 67-10 (Officer Evaluation Report): This form is used for evaluating officers. It shares a similar structure and purpose, assessing leadership, performance, and potential, but is specific to commissioned officers.

  • 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.

  • 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.

  • 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.