DA Form 2166-9-2 NCO Evaluation Report (SSG-1sg/MSG)

What Is DA Form 2166-9-2?

DA Form 2166-9-2, NCO Evaluation Report, SSG-1SG/MSG is a United States Army form used during yearly evaluations of Non-commissioned officers (NCOs) ranked from Staff Sergeant (SSG-1SG) to Master Sergeant (MSG). This form is a part of a series of six forms introduced by the Department of the Army (DA) for purposes of evaluating the performance of senior officers. The DA 2166-9-2 - just like the other NCOER forms - is an organizational report and requires several authorized intermediate and senior raters to provide their assessment of the NCO's annual efforts.

The latest version of the form - sometimes mistakenly referred to as the DD Form 2166-9-2 - was issued in November 2015. An up-to-date fillable DA Form 2166-9-2 is available for download below or can be found on the Army Publications Directorate (APD) website.

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HQDA#:
NCO EVALUATION REPORT (SSG-1SG/MSG)
SEE PRIVACY ACT STATEMENT
IN AR 623-3
For use of this form, see
AR 623-3;
the proponent agency is DCS, G-1.
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
k. RATED
l. NONRATED
m. NO OF
n. RATED NCO'S EMAIL ADDRESS (.gov or .mil)
MONTHS
CODES
ENCLOSURES
FROM
THRU
YEAR MONTH DAY
YEAR MONTH DAY
PART II - AUTHENTICATION
a1. NAME OF RATER (Last, First, Middle Initial)
a3. RATER'S SIGNATURE
a4. DATE (YYYYMMDD
a2. SSN (or DOD ID No.)
a5. RANK
PMOSC/BRANCH
a6. RATER'S EMAIL ADDRESS (.gov or .mil)
ORGANIZATION
DUTY ASSIGNMENT
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
b6. SENIOR RATER'S EMAIL ADDRESS (.gov
ORGANIZATION
DUTY ASSIGNMENT
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.
d2. RATED NCO'S SIGNATURE
d3. DATE (YYYYMMDD)
d1. COUNSELING DATES INITIAL
LATER
LATER
LATER
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.)
c. CHARACTER: (Include bullet comments addressing
COMMENTS:
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
Page 1 of 2
DA FORM 2166-9-2, NOV 2015
APD LC v1.00ES
HQDA#:
NCO EVALUATION REPORT (SSG-1SG/MSG)
SEE PRIVACY ACT STATEMENT
IN AR 623-3
For use of this form, see
AR 623-3;
the proponent agency is DCS, G-1.
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
k. RATED
l. NONRATED
m. NO OF
n. RATED NCO'S EMAIL ADDRESS (.gov or .mil)
MONTHS
CODES
ENCLOSURES
FROM
THRU
YEAR MONTH DAY
YEAR MONTH DAY
PART II - AUTHENTICATION
a1. NAME OF RATER (Last, First, Middle Initial)
a3. RATER'S SIGNATURE
a4. DATE (YYYYMMDD
a2. SSN (or DOD ID No.)
a5. RANK
PMOSC/BRANCH
a6. RATER'S EMAIL ADDRESS (.gov or .mil)
ORGANIZATION
DUTY ASSIGNMENT
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
b6. SENIOR RATER'S EMAIL ADDRESS (.gov
ORGANIZATION
DUTY ASSIGNMENT
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.
d2. RATED NCO'S SIGNATURE
d3. DATE (YYYYMMDD)
d1. COUNSELING DATES INITIAL
LATER
LATER
LATER
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.)
c. CHARACTER: (Include bullet comments addressing
COMMENTS:
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
Page 1 of 2
DA FORM 2166-9-2, NOV 2015
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 bearing, Fitness,
COMMENTS:
Confidence, Resilience)
FAR EXCEEDED
EXCEEDED
MET
DID NOT MEET
STANDARD
STANDARD
STANDARD
STANDARD
e. INTELLECT: (Mental agility, Sound judgement, Innovation,
COMMENTS:
Interpersonal tact, Expertise)
FAR EXCEEDED
EXCEEDED
MET
DID NOT MEET
STANDARD
STANDARD
STANDARD
STANDARD
f. LEADS: (Leads others, Builds trust, Extends influence beyond the
COMMENTS:
chain of command, Leads by example, Communicates)
FAR EXCEEDED
EXCEEDED
MET
DID NOT MEET
STANDARD
STANDARD
STANDARD
STANDARD
g. DEVELOPS: (Creates a positive command/workplace
COMMENTS:
environment, Fosters esprit de corps, Prepares self, Develops
others, Stewards the profession)
MET
DID NOT MEET
FAR EXCEEDED
EXCEEDED
STANDARD
STANDARD
STANDARD
STANDARD
h. ACHIEVES: (Gets results)
COMMENTS:
MET
DID NOT MEET
FAR EXCEEDED
EXCEEDED
STANDARD
STANDARD
STANDARD
STANDARD
RATER OVERALL PERFORMANCE
i. Select one box representing Rated NCO’s overall performance compared to others in the same grade whom you have rated in your career. I currently rate
Army NCOs in this grade.
DID NOT MEET
MET
FAR EXCEEDED
EXCEEDED
STANDARD
STANDARD
STANDARD
STANDARD
j. 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
Army NCOs in this grade.
MOST QUALIFIED (limited to 24%)
HIGHLY QUALIFIED
QUALIFIED
NOT QUALIFIED
c. List two successive assignments and one broadening assignment (3-5 years).
2)
Successive Assignment: 1)
Broadening Assignment:
Page 2 of 2
DA FORM 2166-9-2, NOV 2015
APD LC v1.00ES

Download DA Form 2166-9-2 NCO Evaluation Report (SSG-1sg/MSG)

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DA Form 2166-9-2 Instructions

The DA Form 2166-9-2 is regulated by the Department of the Army Pamphlet 623-3 (Evaluation Reporting System) released in November 2015. The SSG-1SG/MSG NCO Evaluation Report consists of five parts that are filled out by either the rated officer or the raters. The five-part form includes the following sections:

  • A section with administrative data;
  • An authentication;
  • A description of the NCO's duties;
  • An evaluation of performance, professionalism, attributes, and competencies;
  • An assessment of the officer's overall potential.
  1. The first part of the form requires the NCO's personal information. The rater is asked to provide the NCO's name, their personal email address, social security number, information about their unit, rank, the reason for submitting the report, the covered periods, the rated months, the nonrated codes and the number of enclosures.
  2. The second part of the form provides information about the staff that will be giving their assessment on the NCO's performance and professionalism. This part consists of both raters' personal information along with their rank, branch of service and organization.
  3. Another part of the second section is dedicated to a supplementary rater if there is a need to introduce a supplementary rater into the rating chain.
  4. The third and fourth sections of the form are to be completed by the rater in charge of performing the evaluation based on the provided criteria. The sections require a description of the NCO's duties and a brief assessment of their character, presence, intellectual abilities, leadership skills, the potential for development and an attitude for achieving results.
  5. After all of the sections are completed and signed, a senior rater is advised to provide additional comments about the NCO's performance in Section 5.

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