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 Army (DA). An 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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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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HQDA#:
PART V - PERFORMANCE EVALUATION, PROFESSIONALISM, ATTRIBUTES, AND COMPETENCIES (Rater)
a. CHARACTER: (Army Values, Empathy, Warriors Ethos/Service Ethos, Discipline. Fully supports SHARP, EO, and EEO.)
INDICATE YOUR MAJOR PERFORMANCE OBJECTIVES:
LIST SIGNIFICANT CONTRIBUTIONS AND ACCOMPLISHMENTS:
b. PRESENCE: (Military and professional bearing, Fitness, Confidence, Resilience)
APFT GOALS:
CURRENT RECORD APFT:
Date:
a. APFT Pass/Fail/Profile:
(ONLY AS NEEDED)
PU:
SU:
RUN:
HT/WT:
Weight:
Within Standard?
b. Height:
INDICATE YOUR MAJOR PERFORMANCE OBJECTIVES:
LIST SIGNIFICANT CONTRIBUTIONS AND ACCOMPLISHMENTS:
c. INTELLECT: (Mental agility, Sound judgment, Innovation, Interpersonal tact, Expertise)
INDICATE YOUR MAJOR PERFORMANCE OBJECTIVES:
LIST SIGNIFICANT CONTRIBUTIONS AND ACCOMPLISHMENTS:
d. LEADS: (Leads others, Builds trust, Extends influence beyond the chain of command, Leads by example, Communicates)
INDICATE YOUR MAJOR PERFORMANCE OBJECTIVES:
LIST SIGNIFICANT CONTRIBUTIONS AND ACCOMPLISHMENTS:
e. DEVELOPS: (Creates a positive command/workplace environment, Fosters esprit de corps, Prepares self, Develops others, Stewards the
profession)
INDICATE YOUR MAJOR PERFORMANCE OBJECTIVES:
LIST SIGNIFICANT CONTRIBUTIONS AND ACCOMPLISHMENTS:
f. ACHIEVES: (Gets results)
INDICATE YOUR MAJOR PERFORMANCE OBJECTIVES:
LIST SIGNIFICANT CONTRIBUTIONS AND ACCOMPLISHMENTS:
PART VI - SENIOR RATER COMMENTS
DA FORM 2166-9-1A, NOV 2015
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PARTS I-III INSTRUCTIONS. AR 623-3 outlines the administrative requirements necessary to complete these portions of the support form. Some key
requirements:
The rater will -
a. Provide a copy of his or her support form (or equivalent), along with the senior rater's support form (or equivalent), to the rated Soldier at the beginning of
beginning of the rating period.
b.
Discuss the scope of the rated Soldier's duty description with him or her within 30 days after the beginning of the rating period. This counseling will include,
as a minimum, the rated Soldier's duty description and the performance objectives to attain. The discussion will also include the relationship of the duty
description and objectives with the organization's mission, problems, priorities, and similar matters.
c.
Counsel the rated Soldier.
(1)
If the rated Soldier is recently assigned to the organization, the rater may use the counseling to outline a duty description and performance objectives.
This discussion gives the rated Soldier a guide for performance while learning new duties and responsibilities in the unit of assignment.
(2)
If the rater is recently assigned, this first counseling may be used to ask the rated Soldier for an opinion of the duty description and objectives. By
doing this, the rater is given a quick assessment of the rated Soldier and the work situation. It will also help the rater develop the best duty description
and performance objectives for the rated Soldier.
d.
Raters will also conduct quarterly follow-up counseling sessions to discuss performance, update and/or revise developmental tasks, as required, and
assess developmental progress. Summary or key comments will be recorded for inclusion when preparing final NCOERs.
Senior raters and reviewing officials will -
a.
Ensure support forms (or equivalent) are provided to all rated Soldiers they senior rate at the beginning of and throughout the respective rating periods.
b.
Use all reasonable means to become familiar with a rated Soldier's performance. When practical, use personal contact, records, and reports, and the
information provided on the rated Soldier's support form.
The rated NCO plays a significant role in counseling sessions and the evaluation process throughout the rating period. In the event of geographical separation,
correspondence and telephone conversations will be used as alternatives to face-to face counseling followed by face-to-face discussions between the rated
Soldier and the rater at the earliest opportunity.
PART IV INSTRUCTIONS. The rated NCO will provide a list of his/her goals and expectations to the rater and senior rater at the beginning of the rating
period.
PART V INSTRUCTIONS. The rated NCO performance objectives will align with the attributes and competencies required for all NCOs. The overall definition
of each attribute and competency is addressed in the base support form. Key points:
a.
CHARACTER: (Army Values, Empathy, Warriors Ethos/Service Ethos, and Discipline)
Character, a person`s moral and ethical qualities, helps determine what is right and gives a leader motivation to do what is appropriate, regardless of the
circumstances or consequences. An informed ethical conscience consistent with the Army Values strengthens leaders to make the right choices when
faced with tough issues. Army leaders must embody these values and inspire others to do the same. Character is essential to successful leadership. It
determines who people are, how they act, helps determine right from wrong and choose what is right. Elements internal and central to a leader`s core are:
Ш
Army Values - Values are principles, standards, or qualities considered essential for successful leaders. Values are fundamental to help people
discern right from wrong in any situation. The Army has seven values to develop in all Army individuals: loyalty, duty, respect, selfless service,
honor, integrity, and personal courage. The rater will assess the rated Soldier's performance in fostering a climate of dignity and respect and
adhering to the requirements of the SHARP Program. This assessment should identify, as appropriate, any significant actions or contributions the
rated officer or NCO made toward --
(1)
Promoting the personal and professional development of subordinates;
(2)
Ensuring the fair, respectful treatment of unit personnel; and
(3)
Establishing a workplace and overall command climate that fosters dignity and respect for all members of the unit.
(4) This assessment must identify any failures by the rated Soldier to foster a climate of dignity and respect and adhere to the SHARP Program.
Ш
Empathy - The propensity to experience something from another person's point of view. The ability to identify with and enter into another person
feelings and emotions. The desire to care for and take care of Soldiers and others.
Ш
Warrior Ethos/Service Ethos - The internal shared attitudes and beliefs that embody the spirit of the Army profession for Soldiers and Army
Civilians alike.
Ш
Discipline - Control of one's own behavior according to Army Values; mindset to obey and enforce good orderly practices in administrative,
organizational, training, and operational duties.
b. PRESENCE: (Military and professional bearing, Fitness, Confidence, Resilience)
The impression a leader makes on others contributes to his success in leading them. This impression is the sum of a leader`s outward appearance,
demeanor, actions and words. Leaders illustrate through their presence that they care. There is no greater inspiration than leaders who routinely share in
team hardships and dangers. Being where subordinates perform duties allows the leader to have firsthand knowledge of the real conditions Soldiers and Army
Civilians face. Presence is a critical attribute leaders need to understand. It is not just a matter of showing up; actions, words and the manner in which leaders
carry themselves convey presence. A leader`s effectiveness is dramatically enhanced by understanding and developing the following areas:
Ш
Military and professional bearing - Possessing a commanding presence. Projecting a professional image of authority.
Ш
Fitness - Having sound health, strength, and endurance that support one's emotional health and conceptual abilities under prolonged stress.
Ш
Confidence - Projecting self-confidence and certainty in the unit's ability to succeed in its missions. Demonstrating composure and outward calm
through control over one's emotions.
Ш
Resilience - Showing a tendency to recover quickly from setbacks, shock, injuries, adversity, and stress while maintaining a mission and
organizational focus.
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c. INTELLECT: (Mental agility, Sound judgement, Innovation, Interpersonal tact, Expertise)
An Army leader`s intellect draws on the mental tendencies and resources that shape conceptual abilities applied to one`s duties and responsibilities.
Conceptual abilities enable effective problem solving and sound judgment before implementing concepts and plans. They help one think creatively and reason
analytically, critically, ethically and with cultural sensitivity to consider unintended as well as intended consequences. Leaders must anticipate the second- and
third-order effects of their actions. The conceptual components affecting an Army leader`s intellect include:
Ш
Mental agility - Flexibility of mind; the ability to break habitual thought patterns. Anticipating or adapting to uncertain or changing situations; to
think through outcomes when current decisions or actions are not producing desired effects. The ability to apply multiple perspectives and
approaches.
Ш
Sound judgment - The capacity to assess situations shrewdly and draw sound conclusions. The tendency to form sound opinions, make sensible
decisions and reliable guesses. The ability to assess strengths and weaknesses of subordinates, peers, and enemy to create appropriate
solutions and action.
Ш
Innovation - The ability to introduce new ideas based on opportunity or challenging circumstances. Creativity in producing ideas and objects that
are both novel and appropriate.
Ш
Interpersonal tact - The capacity to understand interactions with others. Being aware of how others see you and sensing how to interact with
them effectively. Conscious of character, reactions and motives of self and others and how they affect interactions. Recognizing diversity and
displaying self-control, balance, and stability.
Ш
Expertise - Possessing facts, beliefs, logical assumptions and understanding in relevant areas.
d. LEADS: (Leads others, Builds trust, Extends influence beyond the chain of command, Leads by example, Communicates)
Army leaders apply character, presence, intellect and abilities to the core leader competencies while guiding others toward a common goal and mission
accomplishment. Direct leaders influence others person-to-person, such as a team leader who instructs, encourages hard work and recognizes achievement.
Organizational and strategic leaders influence within their sphere of influence, including immediate subordinates and staffs, but often guide their organizations
using indirect means of influence. At every level, leaders take advantage of formal and informal processes to extend influence beyond the traditional chain of
command. Influence is the essential element of leadership. Influence refers to how people create and relay their messages, behaviors and attitudes to affect
the intentions, beliefs, behaviors and attitudes of another person or group of people. The major forms of influence are commitment and compliance. Army
leaders have choices in influence methods dependent on audience, intent and expected reaction. Leaders use several influence methods that reduce
resistance and fall along a continuum between compliance and commitment. The methods described below seek different degrees of compliance:
Ш
Leads others - Leaders motivate, inspire, and influence others to take initiative, work toward a common purpose, accomplish critical tasks, and
achieve organizational objectives. Influence focuses on compelling others to go beyond their individual interests and to work for the common
good.
Ш
Builds trust - Leaders build trust to mediate relationships and encourage commitment among followers. Trust starts from respect among people
and grows from common experiences and shared understanding.
Ш
Extends influence beyond the chain of command - Leaders need to influence beyond their direct lines of authority and beyond chains of
command to include unified action partners. In these situations, leaders use indirect means of influence: diplomacy, negotiation, mediation,
arbitration, partnering, conflict resolution, consensus building, and coordination.
Ш
Leads by example - Leaders serve as role models. They maintain standards and provide effective examples through their actions. All Army
leaders should model the Army Values. Modeling provides tangible evidence of desired behaviors and reinforces verbal guidance through
demonstration of commitment and action.
Ш
Communicates - Leaders communicate effectively by clearly expressing ideas and actively listening to others. By understanding the nature and
importance of communication and practicing effective communication techniques, leaders will relate better to others and be able to translate goals
into actions. Communication is essential to all other leadership competencies.
e.
DEVELOPS: (Create a positive environment/Fosters esprit de corps, prepares self, Develops others, Stewards the profession)
To have future focus and maintain balance in the present, Army leaders set priorities and weigh competing demands. They carefully steer their organization's
efforts to address short and long term goals, while continuing to meet requirements that could contribute directly to achieving those goals. Accounting for other
demands that vie for an organization`s resources, a leader`s job becomes difficult. Guidance from higher headquarters may help, but leaders have to make the
tough calls to keep a healthy balance. Developing people and the organization with a long-term perspective requires leaders who --
Ш
Create a positive environment/Foster esprit de corps - Leaders establish and maintain positive expectations and attitudes to support effective
work behaviors and healthy relationships. Leaders improve the organization while accomplishing missions. They should leave the organization
better than it was when they arrived.
Ш
Prepares self - Leaders prepare to execute their leadership responsibilities fully. They are aware of their limitations and strengths and seek self-
development. Leaders maintain self-discipline, physical fitness, and mental well-being. They continue to improve the expertise required of their
leadership roles and their profession.
Ш
Develops others - Leaders encourage and support others to grow as individuals and teams. They facilitate the achievement of organizational
goals through helping others to develop. They prepare others to assume new positions elsewhere in the organization, making the organization
more versatile and productive.
Ш
Stewards the profession - Leaders take care of the Army profession by applying a mindset that embodies cooperative planning and management
of all resources, but especially providing for a strong Army team. Leaders actively engage in sustaining full military readiness and preventing the
loss of effectiveness as far into the future as possible.
f.
ACHIEVES: (Gets Results)
Leadership builds effective organization. Effectiveness directly relates to the core leader competency of getting results. From the definition of leadership,
achieving focuses on accomplishing the mission. Mission accomplishment co-exists with an extended perspective towards maintaining and building the
organization`s capabilities. Achieving begins in the short-term by setting objectives. In the long-term, achieving requires getting results in pursuit of those
objectives. Getting results focuses on structuring what needs to be done to produce consistent results. Getting results embraces all actions to get the job
done on time and to standard:
Ш
Gets results - A leader's ultimate purpose is to accomplish tasks and achieve results. A leader gets results by providing guidance and managing
resources, as well as performing the other leader competencies. Gets results focuses on consistent and ethical task accomplishment through
supervising, managing, monitoring, and controlling the work.
DA FORM 2166-9-1A, NOV 2015
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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.

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