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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

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

Document Information

Fact Name Description
Form Purpose The DA 2166-9-1 form is used to evaluate 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 DA Pamphlet 623-3.
Privacy Statement A Privacy Act Statement is included in AR 623-3, ensuring the protection of personal information.
Administrative Data Part I of the form collects essential administrative data, including the NCO's name, SSN, rank, and unit information.
Rater's Role The rater must provide their name, signature, and evaluation of the rated NCO's performance.
Performance Evaluation Part IV assesses various attributes, including character, presence, intellect, leadership, development, and achievement.
Submission Requirements The form requires the rated NCO's acknowledgment of understanding regarding their performance evaluation and the appeals process.

Da 2166 9 1 - Usage Guidelines

Completing the DA Form 2166-9-1 is an essential process for evaluating non-commissioned officers (NCOs). This form requires accurate and thorough input of personal and performance-related information. Following these steps will ensure that the form is filled out correctly.

  1. Part I - Administrative Data:
    • Enter the rated NCO's name (Last, First, Middle Initial).
    • Provide the Social Security Number (SSN) or DOD ID Number.
    • Indicate the NCO's rank.
    • Fill in the date of rank.
    • Input the Primary Military Occupational Specialty Code (PMOSC).
    • List the unit, organization, station, ZIP code or APO, and major command.
    • Specify the status code.
    • Provide the Unit Identification Code (UIC).
    • State the reason for submission.
    • Enter the period covered, including start and end dates.
    • Indicate the rated months.
    • Provide non-rated codes.
    • List the number of enclosures.
    • Enter the rated NCO's email address (.gov or .mil).
  2. Part II - Authentication:
    • Enter the name of the rater (Last, First, Middle Initial).
    • Provide the rater's SSN or DOD ID Number.
    • The rater must sign and date the form.
    • Indicate the rater's rank, PMOSC/branch, and organization duty assignment.
    • Provide the rater's email address (.gov or .mil).
    • Repeat similar steps for the senior rater, including name, SSN, signature, date, rank, and email address.
    • If applicable, fill in supplementary reviewer information and comments.
  3. Part III - Duty Description:
    • Enter the principal duty title.
    • Provide the duty MOSC.
    • Describe daily duties and scope, including people, equipment, facilities, and financial responsibilities.
    • List areas of special emphasis.
    • Include appointed duties.
  4. Part IV - Performance Evaluation:
    • Record the APFT results, including pass/fail/profile status and date.
    • Provide height and weight, noting if within standards.
    • Fill out performance evaluation sections for character, presence, intellect, leads, develops, and achieves, with comments for each.
    • Indicate overall performance rating.
  5. Part V - Senior Rater Overall Potential:
    • Select a box representing the rated NCO's potential compared to others in the same grade.
    • Provide comments on potential.
    • List two successive assignments and one broadening assignment.

After completing the form, review all entries for accuracy. Ensure that all required signatures are obtained before submission. This form plays a crucial role in the evaluation process, impacting career progression and development opportunities for the NCO.

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Dos and Don'ts

When filling out the DA 2166 9 1 form, it's essential to be thorough and accurate. Here are some important do's and don'ts to keep in mind:

  • Do double-check all personal information for accuracy, including your name, SSN, and rank.
  • Do ensure that the dates, especially the date of rank and period covered, are correct.
  • Do provide a clear and detailed description of your duties and responsibilities in Part III.
  • Do use your official email address (.gov or .mil) for all sections requiring an email.
  • Don't leave any required fields blank; all sections must be completed to avoid delays.
  • Don't forget to sign and date the form in the appropriate sections, as your signature is crucial for validation.
  • Don't submit the form without reviewing it for spelling errors or inconsistencies.

Following these guidelines can help ensure that your evaluation report is processed smoothly and accurately. Remember, attention to detail is key.

Common mistakes

  1. Incomplete Administrative Data: Failing to fill out all required fields in Part I, such as the name, SSN, or unit information, can lead to delays or rejections of the evaluation report.

  2. Incorrect Dates: Entering the wrong dates for the period covered or counseling dates can cause confusion regarding the evaluation timeframe.

  3. Missing Signatures: Not obtaining the required signatures from the rater, senior rater, or supplementary reviewer can render the form invalid.

  4. Omitting Required Comments: Failing to provide comments in performance evaluation sections, especially for "Did Not Meet Standard" ratings, can lead to a lack of clarity in the evaluation.

  5. Inaccurate Email Addresses: Providing incorrect email addresses for the rater or senior rater can hinder communication and follow-up regarding the evaluation.

  6. Neglecting to Verify Information: Not reviewing the completed form for accuracy before submission can result in errors that impact the rated NCO's career.

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