DA Form 2166-9-1A NCO Evaluation Report Support Form

What Is DA Form 2166-9-1A?

DA Form 2166-9-1A, NCOER Support Form is a support form that is used for gathering information during the evaluation of U.S. Army Non-commissioned officers (NCOs) in the rank of Sergeant (SGT). This form is a part of the DA 2166-9 series that contains five other rank-specific performance assessment reports.

The latest version of the form - sometimes mistakenly referred to as the DD Form 2166-9-1A - was issued in November 2015 by the Department of the ArmyAn up-to-date fillable DA Form 2166-9-1A is available for download below or can be found on the Army Publications Directorate website.

The SGT NCO being evaluated should receive counseling from a senior rater at least twice during the rating period. Having received counseling, the NCO needs to fill out the form providing a self-assessment of their work goals and expectations, along with a personal evaluation or their professionalism, performance, attributes, and competencies. A senior rater can provide additional comments to the self-evaluation, if necessary.

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HQDA#:
NCO EVALUATION REPORT SUPPORT FORM
SEE PRIVACY ACT STATEMENT
For use of this form, see
AR 623-3;
the proponent agency is DCS, G-1.
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
g. UIC
h. RATED NCO'S EMAIL ADDRESS (.gov or .mil)
f. UNIT, ORG, STATION, ZIP CODE OR APO, MAJOR COMMAND
i. SSD AND NCOES REQUIREMENT MET FOR NEXT GRADE OR NOMINATIVE/JOINT ASSIGNMENT?
MEL:
SSD:
YES
NO
PART II - AUTHENTICATION
a1. NAME OF RATER (Last, First, Middle Initial)
a2. SSN (or DOD ID No.)
INITIAL
DATE LATER
DATE
LATER
DATE LATER
DATE
(YYYYMMDD)
(YYYYMMDD)
(YYYYMMDD)
(YYYYMMDD)
a3. RANK
PMOSC/BRANCH
a4. RATER'S EMAIL ADDRESS (.gov or .mil)
DUTY ASSIGNMENT
ORGANIZATION
b1. NAME OF SENIOR RATER (Last, First, Middle Initial)
b2. SSN (or DOD ID No.)
INITIAL
DATE
LATER
DATE
(YYYYMMDD)
(YYYYMMDD)
b3. RANK
PMOSC/BRANCH
b6. SENIOR RATER'S EMAIL ADDRESS (.gov
ORGANIZATION
DUTY ASSIGNMENT
or .mil)
c2. SSN (or DOD ID No.)
c1. NAME OF SUPPLEMENTARY REVIEWER (Last, First, Middle Initial)
ORGANIZATION
DUTY ASSIGNMENT
PMOSC/BRANCH
c3. RANK
c4. SUPPLEMENTARY REVIEWER'S EMAIL ADDRESS
(.gov or .mil)
INITIAL
DATE
LATER
DATE LATER
DATE
LATER
DATE
d. RATED NCO'S INITIALS
(YYYYMMDD)
(YYYYMMDD)
(YYYYMMDD)
(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 GOALS AND EXPECTATIONS (Rated NCO)
INDICATE YOUR PERFORMANCE GOALS AND EXPECTATIONS DURING THIS RATING PERIOD:
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DA FORM 2166-9-1A, NOV 2015
APD LC v1.00ES

Download DA Form 2166-9-1A NCO Evaluation Report Support Form

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DA Form 2166-9-1A Instructions

The DA Form 2166-9-1A is regulated by the Army Pamphlet 623–3 (Evaluation Reporting System) released in November 2015. The form consists of four sections: administrative data, authentication, a duty description (filled out by the rater) and a review of performance goals and expectations (filled out by the Non-commissioned officer being evaluated).

  1. The evaluated NCO is required to provide some of their personal information in the first part of the form. This includes their name, social security number, rank, email address, and information on their unit. It is also necessary to state whether all Structured Self Development (SSD) and Noncommissioned Officer Education System (NCOES) requirements were met for the next grade or nominative assignment (thus showing potential for promotion).
  2. The second part of the form should provide identifying information on the rater and senior rater who will be performing the assessment of the NCO’s performance and professionalism. This part requires the raters' names, social security numbers, and email addresses. Both raters must provide information on their rank, branch, duty, and organization. Both raters must sign and date the document in the appropriate columns.
  3. The third part of the DA 2166-9-1A - Duty Description - should be filled out by the rater. The last part is to be completed by the NCO – they are required to describe their expectations and goals for the upcoming evaluation period.

DA 2166-9-1A Related Forms

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