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Free Da 2166 9 1 PDF Form

The DA Form 2166-9-1 is an essential document used for the Non-Commissioned Officer Evaluation Report (NCOER) for sergeants in the U.S. Army. This form captures critical information about an NCO's performance, including their duties, evaluations, and potential for future assignments. To ensure accuracy and compliance, it is vital to complete this form correctly; start filling it out by clicking the button below.

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Outline

The DA Form 2166-9-1 is a crucial document in the evaluation process of Non-Commissioned Officers (NCOs) within the U.S. Army. This form serves as the NCO Evaluation Report specifically for the rank of Sergeant, capturing essential administrative data, performance evaluations, and overall potential assessments. The form requires detailed information about the rated NCO, including their name, Social Security Number, rank, and unit, among other identifiers. It also encompasses sections for rater and senior rater authentication, ensuring that evaluations are conducted by qualified individuals. The evaluation criteria are comprehensive, covering various aspects such as character, presence, intellect, leadership, development, and achievement. Each of these categories includes specific comments that reflect the NCO's adherence to Army values and their overall performance. Additionally, the form addresses the rated NCO's physical fitness and compliance with weight standards, which are vital to their role. By providing a structured framework for assessment, the DA Form 2166-9-1 not only facilitates a fair evaluation process but also plays a significant role in the career progression of NCOs.

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Key takeaways

Filling out the DA 2166-9-1 form is crucial for evaluating non-commissioned officers (NCOs). Here are some key takeaways to keep in mind:

The form is specifically designed for NCO evaluation reports, primarily for the rank of Sergeant.
Ensure that all administrative data in Part I is accurate. This includes the NCO's name, Social Security Number (SSN), rank, and unit information.
Part II requires signatures from the rater and senior rater, confirming their assessments and the accuracy of the information provided.
The rated NCO must acknowledge their understanding of the report by signing in Part II, even if they disagree with the evaluations.
In Part III, provide a clear and detailed description of the NCO's daily duties, emphasizing any special responsibilities.
Part IV focuses on performance evaluation. Each section, such as character and presence, should include specific comments and observations.
Be mindful of the APFT (Army Physical Fitness Test) results. Comments are necessary if the NCO fails to meet standards.
When assessing potential in Part V, select the most appropriate box that reflects the NCO's capabilities compared to peers.
List two successive assignments and one broadening assignment in Part V to provide context for the NCO's career trajectory.
Finally, remember to keep a copy of the completed form for future reference, as it may be needed for appeals or further evaluations.

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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

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

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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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.
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:

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