Blank Da 2166 9 1 PDF Form

Blank Da 2166 9 1 PDF Form

The DA 2166-9-1 form is a critical document used in the U.S. Army to evaluate the performance of Non-Commissioned Officers (NCOs). This evaluation report helps to assess an NCO's professional attributes, competencies, and overall potential, thereby influencing their career progression and opportunities. Completing this form accurately is essential for maintaining the integrity of the evaluation process.

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The DA Form 2166-9-1, commonly referred to as the NCO Evaluation Report for Sergeants, serves as a vital tool in the evaluation of non-commissioned officers within the U.S. Army. This form plays a significant role in documenting the performance and potential of NCOs, providing a structured format for rater and senior rater assessments. It includes several key sections that gather essential information about the rated individual, including administrative data such as name, rank, and duty assignment. The evaluation process is initiated by the rater, who assesses the NCO's performance across various attributes, including character, presence, intellect, leadership, development, and achievement. Each of these areas is accompanied by specific comments that highlight the NCO's strengths and areas for improvement. Additionally, the form requires the rater and senior rater to authenticate their assessments through signatures and dates, ensuring accountability and transparency. The rated NCO also has the opportunity to acknowledge their understanding of the report's contents and the appeals process, adding another layer of engagement in their professional development. Ultimately, the DA Form 2166-9-1 not only serves as a performance evaluation but also contributes to the broader goals of leadership development and career progression within the Army.

Document Sample

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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

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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

 

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File Specifics

Fact Name Description
Form Purpose The DA 2166 9 1 form is used for evaluating the performance of Non-Commissioned Officers (NCOs) at the rank of Sergeant.
Governing Regulations This form is governed by Army Regulation (AR) 623-3 and Department of the Army Pamphlet (DA PAM) 623-3.
Privacy Act Compliance The form includes a Privacy Act Statement, ensuring that personal information is handled in accordance with federal regulations.
Submission Details Information required for submission includes the rated NCO’s name, social security number, rank, and the period covered by the evaluation.
Signatures Required Signatures from the rater, senior rater, and supplementary reviewer are mandatory to authenticate the evaluation process.

How to Use Da 2166 9 1

Filling out the DA 2166-9-1 form is an important task that requires careful attention to detail. This form is used for the NCO evaluation report, and it includes various sections that need to be completed accurately. Once you have filled out the form, it will be submitted to the appropriate channels for review and processing.

  1. Begin with Part I - Administrative Data. Fill in your name (last, first, middle initial), SSN (or DOD ID No.), rank, date of rank, PMOSC, unit/organization, station, ZIP code or APO, major command, status code, UIC, reason for submission, period covered (from and through), rated months, non-rated codes, number of enclosures, and rated NCO's email address.
  2. Move to Part II - Authentication. Enter the name of the rater, their SSN (or DOD ID No.), signature, date, rank, PMOSC/branch, organization, duty assignment, and email address. Repeat this for the senior rater and include the supplementary reviewer if applicable.
  3. In the Rated NCO section, acknowledge understanding of your signature's implications regarding the report. Fill in the counseling dates and sign with the date.
  4. Proceed to Part III - Duty Description. Provide the principal duty title, duty MOSC, daily duties and scope, areas of special emphasis, and appointed duties.
  5. Next, complete Part IV - Performance Evaluation. Assess performance in various categories: APFT pass/fail/profile, height, weight, presence, intellect, leads, develops, and achieves. Include comments for each category as needed.
  6. Finally, in Part V - Senior Rater Overall Potential, select the appropriate box for the rated NCO's potential and provide comments. List two successive assignments and one broadening assignment.

Your Questions, Answered

What is the purpose of the DA 2166 9 1 form?

The DA 2166 9 1 form is used for evaluating Non-Commissioned Officers (NCOs) in the U.S. Army, specifically at the rank of Sergeant. It serves to document the performance and potential of NCOs, providing a structured way for raters and senior raters to assess various competencies. This evaluation plays a crucial role in personnel decisions, promotions, and career development within the Army.

Who is responsible for filling out the DA 2166 9 1 form?

The primary responsibility for completing the DA 2166 9 1 form lies with the rater, who is typically the NCO's immediate supervisor. The rater must provide detailed assessments in several categories, including character, presence, intellect, leadership, development, and achievement. Senior raters, who are usually in a higher position, must also review and provide their input on the evaluation. Additionally, the rated NCO must acknowledge the evaluation by signing the form, which confirms that they have seen the report and understand the information presented.

What information is required in Part I of the DA 2166 9 1 form?

Part I of the DA 2166 9 1 form collects essential administrative data about the rated NCO. This includes:

  1. Name (Last, First, Middle Initial)
  2. Social Security Number (or DOD ID Number)
  3. Rank and Date of Rank
  4. Unit or Organization Information
  5. Status Code and UIC
  6. Reason for Submission
  7. Period Covered by the Evaluation
  8. Rated Months and Nonrated Codes
  9. Number of Enclosures
  10. Rated NCO's Email Address

This information is critical for ensuring that the evaluation is accurate and properly attributed to the correct individual.

How does the appeals process work for the DA 2166 9 1 form?

If a rated NCO disagrees with their evaluation, they have the right to appeal. The appeals process is outlined in AR 623-3. The NCO should first discuss their concerns with the rater or senior rater. If the issue remains unresolved, the NCO can submit a formal appeal. This appeal must include specific reasons for the disagreement and any supporting evidence. The chain of command will review the appeal, and a decision will be made based on the merits of the case. It is essential for NCOs to understand this process, as it provides a means to address potential inaccuracies or unfair assessments.

Common mistakes

  1. Incomplete Personal Information: Failing to provide complete details in the administrative data section can lead to processing delays. Ensure that all fields, including name, SSN, and rank, are filled out accurately.

  2. Missing Signatures: All required signatures must be included. This includes the rater, senior rater, and supplementary reviewer. Omitting any signature may result in the form being deemed invalid.

  3. Incorrect Dates: Using the wrong date format or entering incorrect dates can create confusion. Dates should be entered in the YYYYMMDD format as specified in the instructions.

  4. Failure to Review Comments: Not thoroughly reviewing the comments section can lead to misunderstandings. It's crucial to ensure that all comments reflect accurate assessments and are clearly articulated.

  5. Neglecting Email Addresses: Providing an incorrect or missing email address for the rated NCO and raters can hinder communication. Make sure that all email addresses are valid and formatted correctly.

Documents used along the form

The DA Form 2166-9-1 is an essential document used in the evaluation of Non-Commissioned Officers (NCOs) in the U.S. Army. However, it is often accompanied by several other forms and documents that help provide a comprehensive view of an NCO's performance and potential. Below is a list of six commonly used documents that complement the DA Form 2166-9-1.

  • DA Form 2166-9-2: This form is the NCO Evaluation Report for the rank of Staff Sergeant and above. It serves a similar purpose as the DA Form 2166-9-1 but is tailored for higher-ranking NCOs. It evaluates their leadership abilities, performance, and potential for advancement.
  • DA Form 4856: Known as the Developmental Counseling Form, this document is used to record counseling sessions between leaders and soldiers. It helps in tracking an NCO’s development and can provide context for evaluations.
  • DA Form 705: This is the Army Physical Fitness Test Scorecard. It documents the results of an NCO's physical fitness test, which is a crucial aspect of their overall performance evaluation and must be reported in the DA Form 2166-9-1.
  • DA Form 5500: This form is used to record body fat measurements for soldiers who do not meet the Army's height and weight standards. It can be relevant when assessing an NCO's compliance with physical fitness standards.
  • DA Form 638: This is the Recommendation for Award form. It is used to recommend soldiers for awards and decorations. A history of awards can impact an NCO's evaluation and potential for promotion.
  • AR 623-3: This Army Regulation outlines the policies and procedures for the evaluation of Army personnel. It provides guidance on how the DA Form 2166-9-1 and other related forms should be completed and used.

These documents work together to create a well-rounded picture of an NCO's performance, potential, and overall contributions to the Army. Understanding how each form interacts with the DA Form 2166-9-1 can help ensure that evaluations are thorough and accurate, ultimately supporting the professional development of our military leaders.

Similar forms

The DA Form 2166-9-1 is a Noncommissioned Officer Evaluation Report (NCOER) specifically designed for Sergeants. A similar document is the DA Form 2166-9, which serves as the overall evaluation for NCOs in various ranks. Both forms assess performance and potential, but the 2166-9 is applicable for higher ranks, such as Staff Sergeants and Sergeants First Class. The structure of both forms includes sections for administrative data, performance evaluation, and authentication by raters and senior raters, ensuring a consistent evaluation process across different ranks.

Another related document is the DA Form 67-9, which is the Officer Evaluation Report (OER). While the DA Form 2166-9-1 focuses on NCOs, the OER evaluates commissioned officers. Both forms require detailed assessments of leadership qualities, professional attributes, and overall potential. They share a similar format, including sections for rater comments and ratings, making it easier to compare evaluations across different ranks and roles within the Army.

The DA Form 1059 is the Service School Academic Evaluation Report (AER). This document evaluates the performance of soldiers during formal training courses. Like the DA Form 2166-9-1, it emphasizes the importance of performance metrics and includes sections for comments from instructors. Both forms aim to provide a comprehensive overview of a soldier's capabilities, though the AER is more focused on academic achievements rather than overall job performance.

The DA Form 4856, known as the Developmental Counseling Form, is another document with similar objectives. It is used for documenting counseling sessions between leaders and soldiers. Both the DA Form 2166-9-1 and the 4856 focus on personal and professional development. However, while the NCOER is a formal evaluation, the counseling form serves as a tool for ongoing mentorship and guidance, allowing for continuous improvement.

The DA Form 7500 is the Army Physical Fitness Test (APFT) Scorecard. This document tracks a soldier's physical fitness performance, which is a critical aspect of the evaluation on the DA Form 2166-9-1. Both documents address the physical readiness of soldiers, with the APFT Scorecard providing specific metrics that can impact the overall performance rating on the NCOER.

The DA Form 638 is the Recommendation for Award. This document is used to recommend soldiers for various awards and honors based on their performance. While the DA Form 2166-9-1 evaluates ongoing performance, the DA Form 638 highlights specific achievements and contributions. Both forms require input from leaders and emphasize the importance of recognizing exemplary service within the Army.

The DA Form 4187, known as the Personnel Action Form, serves to document various personnel actions, including promotions and reassignments. While the DA Form 2166-9-1 focuses on performance evaluation, the 4187 is essential for tracking career progression. Both documents require accurate administrative data and signatures from appropriate authorities, ensuring that personnel records remain up-to-date and reflective of a soldier's career.

The DA Form 200 is the Transmittal Record, which is used to document the transfer of property and equipment. Although this form is not directly related to performance evaluation, it shares the common goal of maintaining accurate records within the Army. Both forms emphasize accountability and transparency in the management of personnel and resources.

Finally, the DA Form 1, known as the Morning Report, provides daily updates on unit strength and personnel status. While it serves a different purpose, both the Morning Report and the DA Form 2166-9-1 contribute to the overall management of soldiers within the Army. They both require timely and accurate reporting to ensure that leadership has a clear understanding of personnel capabilities and needs.

Dos and Don'ts

When filling out the DA 2166-9-1 form, attention to detail is crucial. Here’s a helpful list of things you should and shouldn’t do to ensure accuracy and compliance.

  • Do double-check all personal information, including your name, SSN, and rank.
  • Do ensure that the dates are formatted correctly (YYYYMMDD) throughout the form.
  • Do provide a clear and concise duty description in Part III to reflect your responsibilities accurately.
  • Do include your email address in the appropriate sections to facilitate communication.
  • Do review the completed form for any spelling or grammatical errors before submission.
  • Don't leave any required fields blank; incomplete forms can lead to delays.
  • Don't use personal email addresses; stick to .gov or .mil addresses for official communication.
  • Don't forget to sign and date the form where required, as this confirms your understanding and agreement.
  • Don't rush through the evaluation comments; thoughtful feedback is essential for a fair assessment.

By following these guidelines, you can help ensure that your DA 2166-9-1 form is filled out correctly and efficiently. This attention to detail not only reflects well on you but also helps maintain the integrity of the evaluation process.

Misconceptions

Understanding the DA Form 2166-9-1 is essential for both NCOs and their evaluators. However, several misconceptions often arise regarding this important document. Here are five common misunderstandings:

  • Misconception 1: The form is only for negative evaluations.
  • Many believe that the DA Form 2166-9-1 is solely used to document poor performance. In reality, it serves to recognize both strengths and areas for improvement. Positive feedback is just as crucial as constructive criticism.

  • Misconception 2: Signing the form means agreeing with the evaluation.
  • Some NCOs think that their signature on the form indicates agreement with the rater's assessment. In fact, the signature merely confirms that the NCO has reviewed the report and that the administrative data is accurate.

  • Misconception 3: The form is not important for career advancement.
  • This is a significant misconception. The DA Form 2166-9-1 plays a vital role in determining an NCO's potential for promotion and future assignments. A well-completed form can open doors for advancement.

  • Misconception 4: Only the rater's comments matter.
  • While the rater's input is crucial, the senior rater's evaluation also holds significant weight. Both perspectives contribute to a comprehensive view of the NCO's performance and potential.

  • Misconception 5: The evaluation process is solely a formality.
  • Some may view the evaluation as a mere bureaucratic step. However, it is a critical part of professional development, providing feedback that can help shape an NCO’s career trajectory.

Key takeaways

When filling out and using the DA 2166-9-1 form, there are several important considerations to keep in mind. Understanding these can ensure the process is completed accurately and effectively.

  • Accurate Administrative Data: Ensure that all personal information in Part I, such as name, rank, and unit, is correct. This data is essential for the validity of the evaluation.
  • Rater and Senior Rater Information: Provide complete and accurate details about the rater and senior rater in Part II. Their signatures confirm the authenticity of the evaluation.
  • Performance Evaluation: In Part IV, focus on providing specific examples and comments that reflect the rated NCO's performance across various competencies. This section is critical for assessing overall effectiveness.
  • Understanding the Appeals Process: The rated NCO should be aware of their rights regarding the appeals process as outlined in AR 623-3. This knowledge is vital in case of any disagreements about the evaluation.