Free Da 2166 9 1 PDF Form

Free Da 2166 9 1 PDF Form

The DA Form 2166-9-1 is an official document used for the evaluation of Non-Commissioned Officers (NCOs) in the U.S. Army, specifically for the rank of Sergeant. This form facilitates the assessment of an NCO's performance and potential, providing a structured format for feedback from both raters and senior raters. It includes sections for administrative data, duty descriptions, and performance evaluations, ensuring a comprehensive review process.

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The DA 2166-9-1 form plays a crucial role in the evaluation of Non-Commissioned Officers (NCOs) in the United States Army, specifically for the rank of Sergeant. This form is designed to assess an NCO's performance, professionalism, attributes, and competencies over a specified period. It includes essential administrative data such as the NCO's name, social security number, rank, unit, and reason for submission. The evaluation process involves multiple layers of authentication, requiring signatures from both the rater and the senior rater, along with their respective email addresses. The form also outlines the duty description, which provides a clear picture of the NCO's responsibilities and areas of special emphasis. Performance evaluation is a significant component, addressing various attributes like character, presence, intellect, leadership, development, and achievement. Each attribute is assessed with specific criteria, allowing for a comprehensive overview of the NCO's capabilities. Furthermore, the senior rater provides an overall potential rating, comparing the rated NCO to peers and identifying future assignment opportunities. The DA 2166-9-1 is not just a form; it is a vital tool for professional development and accountability within the Army, ensuring that NCOs are recognized for their contributions and guided in their career progression.

Da 2166 9 1 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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Documents used along the form

The DA Form 2166-9-1 is an essential document used for evaluating the performance of Non-Commissioned Officers (NCOs) in the U.S. Army. This form is often accompanied by several other documents that provide additional context and support for the evaluation process. Below is a list of commonly used forms and documents that may be required alongside the DA Form 2166-9-1.

  • DA Form 4856: This form is used for counseling sessions. It documents the discussions between a leader and a soldier regarding performance, expectations, and development. It serves as a critical tool for providing feedback and guidance.
  • DA Form 705: This document records the results of the Army Physical Fitness Test (APFT). It includes details about the soldier's performance in physical fitness and is important for assessing overall readiness and capability.
  • DA Form 5500/5501: These forms are used to record body composition data. They help ensure that soldiers meet Army height and weight standards, which is a key factor in maintaining military readiness.
  • DA Form 67-9: This is the Officer Evaluation Report (OER) form. While it is specific to officers, it may be referenced during the evaluation of NCOs to provide context on leadership and performance expectations within the unit.
  • Durable Power of Attorney form: This document allows you to designate someone to make decisions on your behalf, ensuring your financial and healthcare wishes are respected. To learn more, visit Missouri PDF Forms.
  • DA Form 11-2: This form is a performance counseling checklist that assists leaders in conducting effective counseling sessions. It includes guidelines and topics to cover, ensuring that all critical areas are addressed during discussions.

Each of these documents plays a vital role in the evaluation and development process within the Army. They help create a comprehensive view of a soldier's performance and potential, ensuring that evaluations are fair, accurate, and supportive of career growth.

Key takeaways

When filling out and using the DA 2166-9-1 form, keep the following key takeaways in mind:

  • Accurate Information is Crucial: Ensure that all personal and administrative data, such as name, SSN, and unit information, is entered correctly. Mistakes can lead to processing delays.
  • Understand the Sections: Familiarize yourself with each part of the form. It includes sections for administrative data, authentication, duty description, performance evaluation, and senior rater potential.
  • Signatures Matter: The signatures of the rated NCO, rater, and senior rater are essential. They confirm that all parties acknowledge the information presented, even if there are disagreements.
  • Performance Evaluation is Key: The performance evaluation section requires specific comments on various attributes such as character, presence, and intellect. Provide clear and constructive feedback.
  • Know the Appeals Process: Rated NCOs should be aware of their right to appeal the evaluations as outlined in AR 623-3. Understanding this process can be important if there are concerns about the assessment.
  • Use the Right Email: When providing email addresses, ensure they are .gov or .mil. This maintains the security and integrity of the information shared.

Form Overview

Fact Name Details
Purpose The DA 2166-9-1 form is used for evaluating the performance of Non-Commissioned Officers (NCOs) in the U.S. Army.
Governing Regulation This form is governed by Army Regulation (AR) 623-3 and DA Pamphlet (PAM) 623-3.
Privacy Act Compliance The form includes a Privacy Act Statement, ensuring the protection of personal information.
Submission Requirements It requires detailed administrative data, including the NCO's name, SSN, rank, and duty information.
Authentication Process Raters and senior raters must sign and date the form, verifying the accuracy of the evaluation.

Frequently Asked Questions

What is the DA 2166 9 1 form used for?

The DA 2166 9 1 form is an NCO Evaluation Report specifically designed for Sergeants (SGT). It serves as a tool to assess the performance and potential of non-commissioned officers in the Army. This evaluation helps in making decisions about promotions, assignments, and career development.

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

The form is typically completed by the rater, who is the immediate supervisor of the NCO being evaluated. The senior rater, who is usually one level above the rater, also plays a crucial role in the evaluation process. Both individuals must provide their signatures and necessary information to authenticate the report.

What information is required in Part I of the form?

Part I of the form collects administrative data about the rated NCO. This includes:

  • Name (Last, First, Middle Initial)
  • Social Security Number or DOD ID Number
  • Rank and Date of Rank
  • Unit, Organization, Station, and ZIP Code or APO
  • Reason for Submission
  • Period Covered by the Evaluation

Completing this section accurately is essential for proper identification and record-keeping.

What is the purpose of the performance evaluation sections in Part IV?

Part IV focuses on evaluating the NCO's performance across several key areas, including character, presence, intellect, leadership, development, and achievement. Each area requires specific comments from the rater, detailing how the NCO meets or does not meet the established standards. This section is vital for providing a comprehensive view of the NCO's capabilities and contributions.

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

After the evaluation is completed, the rated NCO has the right to review the report. If there are disagreements with the assessment, the NCO can initiate an appeal as outlined in AR 623-3. This process allows NCOs to formally contest any part of their evaluation they believe to be inaccurate or unfair.

What are the responsibilities of the rater and senior rater?

The rater is responsible for the initial evaluation and must provide detailed comments based on the NCO's performance. The senior rater reviews the rater's evaluation and provides an overall assessment of the NCO's potential compared to peers. Both individuals must ensure that the information is accurate and reflective of the NCO's performance.

What is included in the Duty Description section?

The Duty Description section outlines the principal duties and responsibilities of the rated NCO. It includes:

  • Principal Duty Title
  • Daily Duties and Scope
  • Areas of Special Emphasis
  • Appointed Duties

This section provides context for the evaluation and helps clarify the NCO's role within their unit.

What does the "Overall Potential" section assess?

The "Overall Potential" section is completed by the senior rater and assesses the rated NCO's potential compared to others in the same grade. The senior rater selects a category such as "Most Qualified," "Highly Qualified," or "Not Qualified." This assessment can significantly influence the NCO's career trajectory.

Are there any confidentiality concerns with the DA 2166 9 1 form?

Yes, the DA 2166 9 1 form contains sensitive personal information, including Social Security Numbers and evaluation details. It is important to handle this form with care and ensure that it is stored securely to protect the privacy of the individuals involved. Following the guidelines set forth in the Privacy Act is crucial.

Misconceptions

Understanding the DA 2166 9 1 form is crucial for service members, yet several misconceptions persist. Here are four common misunderstandings:

  • Misconception 1: The form is only for negative evaluations.
  • This is not true. The DA 2166 9 1 form is used to assess both positive and negative performance. It aims to provide a comprehensive view of an NCO's capabilities, contributions, and areas for improvement.

  • Misconception 2: Signing the form means agreement with the evaluation.
  • Many believe that signing the form indicates agreement with the ratings. In reality, the signature only confirms that the administrative data is correct and that the NCO has seen the completed report. It does not imply acceptance of the evaluation's content.

  • Misconception 3: The DA 2166 9 1 is not important for career advancement.
  • This form plays a significant role in career progression. It influences promotion decisions and future assignments. A well-documented evaluation can enhance an NCO's prospects for advancement.

  • Misconception 4: The evaluation process is solely the responsibility of the rater.
  • While the rater plays a key role, the senior rater and supplementary reviewers also contribute. Their insights help create a more balanced evaluation, ensuring a fair assessment of the NCO's performance.