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Fill Out a Valid Da 2166 9 1 Template

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Content Overview

Guide to Writing Da 2166 9 1

Filling out the DA 2166-9-1 form is an important step in the evaluation process for Non-Commissioned Officers (NCOs). This form collects essential information regarding the rated NCO’s performance, potential, and other administrative data. Completing it accurately ensures that evaluations are fair and reflective of the NCO's contributions.

  1. Part I - Administrative Data:
    • Enter the rated NCO’s name (Last, First, Middle Initial).
    • Provide the SSN or DOD ID Number.
    • Fill in the rank of the rated NCO.
    • Indicate the date of rank.
    • Input the PMOSC (Primary Military Occupational Specialty Code).
    • List the unit, organization, station, ZIP code or APO, and major command.
    • Specify the status code.
    • Provide the UIC (Unit Identification Code).
    • State the reason for submission.
    • Indicate the period covered by the evaluation (from and through dates).
    • Enter the number of rated months.
    • Fill in non-rated codes as applicable.
    • List the number of enclosures.
    • Provide the rated NCO's email address (either .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.
    • Have the rater sign the form.
    • Fill in the date of the signature (YYYYMMDD).
    • Indicate the rater's rank, PMOSC/branch, and organization duty assignment.
    • Provide the rater's email address (either .gov or .mil).
    • Enter the name of the senior rater (Last, First, Middle Initial).
    • Provide the senior rater's SSN or DOD ID Number.
    • Have the senior rater sign the form.
    • Fill in the date of the signature (YYYYMMDD).
    • Indicate the senior rater's rank, PMOSC/branch, and organization duty assignment.
    • Provide the senior rater's email address (either .gov or .mil).
    • Complete supplementary review details if applicable.
  3. Part III - Duty Description (Rater):
    • Enter the principal duty title.
    • Provide the duty MOSC.
    • Detail daily duties and scope, including people, equipment, facilities, and dollars.
    • List areas of special emphasis.
    • Include appointed duties.
  4. Part IV - Performance Evaluation:
    • Indicate APFT pass/fail/profile status and date.
    • Record height and weight, and confirm if within standard.
    • Evaluate character, presence, intellect, leadership, development, and achievement, providing comments for each area.
    • Complete the rater overall performance section.
  5. Part V - Senior Rater Overall Potential:
    • Select a box that represents the rated NCO’s potential.
    • Provide comments regarding the rated NCO’s potential.
    • List two successive assignments and one broadening assignment.

Once you have completed the form, review all entries for accuracy. Ensure that all required signatures are obtained. This form will then be submitted as part of the NCO evaluation process, contributing to the overall assessment of the NCO's performance and potential for future assignments.

Document Breakdown

Fact Name Description
Form Purpose The DA 2166-9-1 form is used for the NCO Evaluation Report specifically for Sergeants (SGT).
Governing Regulations This form is governed by AR 623-3 and DA PAM 623-3, which outline the procedures for evaluation of non-commissioned officers.
Privacy Statement A Privacy Act Statement is included in AR 623-3, ensuring the protection of personal information on the form.
Submission Requirements The form requires detailed administrative data, including the rated NCO's name, rank, and period covered by the evaluation.
Authentication Authentication is required from the rater, senior rater, and supplementary reviewer, with signatures and dates included.

FAQ

What is the DA Form 2166-9-1 used for?

The DA Form 2166-9-1 is an NCO Evaluation Report specifically for the rank of Sergeant (SGT). It is used to evaluate the performance and potential of non-commissioned officers in the U.S. Army. This form helps to provide a standardized assessment of an NCO's abilities and contributions to their unit.

Who is responsible for completing the DA Form 2166-9-1?

The form must be completed by the rater, who is typically the immediate supervisor of the rated NCO. The senior rater, usually a higher-ranking officer, also plays a role in the evaluation process. Both individuals must provide their signatures to validate the report.

What information is required in Part I of the form?

Part I collects administrative data about the rated NCO, including:

  1. Name
  2. Social Security Number (or DOD ID Number)
  3. Rank and Date of Rank
  4. Unit and organizational information
  5. Reason for submission and period covered by the evaluation

This information ensures that the evaluation is accurately associated with the correct individual.

How are performance evaluations structured in the form?

Performance evaluations are structured in Part IV and include several categories such as:

  • Character
  • Presence
  • Intellect
  • Leadership
  • Development
  • Achievement

Each category requires the rater to assess whether the NCO met the standard and to provide comments that support their evaluation.

What is the significance of the rater's and senior rater's signatures?

The signatures of both the rater and senior rater confirm that they have reviewed the evaluation and agree with its contents. The rater's signature also indicates that the rated NCO has seen the completed report, even if they do not agree with the assessments.

Can the rated NCO appeal the evaluation?

Yes, the rated NCO has the right to appeal the evaluation. The process for appeals is outlined in AR 623-3. It is important for the NCO to be aware of this process if they feel the evaluation does not accurately reflect their performance.

What should be included in the duty description section?

The duty description section requires details such as:

  1. Principal duty title
  2. Daily duties and scope of responsibilities
  3. Areas of special emphasis
  4. Appointed duties

This section provides context for the rated NCO's performance and helps evaluators understand their role within the unit.

How often should the DA Form 2166-9-1 be completed?

The DA Form 2166-9-1 should be completed annually or at the end of a rated period. It is essential to ensure that evaluations reflect the most current performance and potential of the NCO.

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Da 2166 9 1 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

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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.

 

 

 

 

 

 

 

 

 

 

 

 

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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