DA Form 7222 Senior System Civilian Evaluation Report

What Is DA Form 7222?

DA Form 7222, Senior System Civilian Evaluation Report is used as a record of written appraisal for civilian personnel in the Senior System. The Senior system is a performance evaluation system covering civilian employees of the following pay grades: SES, SL, ST, GM, WS or GS-9. There are two types of appraisals:

  • Annual, with the rating period covering a single year;
  • Special, obtained when the Ratee is temporarily promoted, detailed, or assigned away from their normal duties in any other way.

The latest edition of the form - sometimes incorrectly referred to as the DD Form 7222 - was released by the Department of the Army (DA) in March 2010 with all previous editions being obsolete. An up-to-date DA Form 7222 fillable version is available for digital filing and download below or can be found through the Army Publishing Directorate website.

The DA Form 7222 is usually distributed with the related DA Form 7222-1, Senior System Civilian Evaluation Report Support Form, used to record performance plans for the Ratees in the Senior System.

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SENIOR SYSTEM CIVILIAN EVALUATION REPORT
For use of this form, see AR 690-400; the proponent agency is ASA(M&RA).
PART I - ADMINISTRATIVE DATA
a. NAME (Last, First, Middle Initial)
b. POSITION TITLE, PAY PLAN, SERIES AND GRADE
c. ORGANIZATION/INSTALLATION
d. REASON FOR SUBMISSION
ANNUAL
SPECIAL
INTERN
e. PERIOD COVERED (YYYYMMDD)
f. RATED MOS.
g. RATEE COPY (Check one and date)
FROM
THRU
GIVEN TO RATEE
FORWARDED TO RATEE
PART II - AUTHENTICATION
SIGNATURE
DATE (YYYYMMDD)
a. NAME OF RATER
(Last, First, Middle Initial)
GRADE/RANK, ORGANIZATION, DUTY ASSIGNMENT
SIGNATURE
DATE (YYYYMMDD)
b. NAME OF INTERMEDIATE RATER
(Optional)(Last, First, MI)
GRADE/RANK, ORGANIZATION, DUTY ASSIGNMENT
SIGNATURE
DATE (YYYYMMDD)
c. NAME OF SENIOR RATER
(Last, First, Middle Initial)(If used)
GRADE/RANK, ORGANIZATION, DUTY ASSIGNMENT
d. RATEE: I understand my signature does not constitute
SIGNATURE OF RATEE
DATE (YYYYMMDD)
agreement or disagreement with the evaluations of the
Rater and Senior Rater, and merely verifies Part I and Part
IV data.
PART III - PERFORMANCE AWARD/QUALITY STEP INCREASE
a.
b. ST, SL, GM, GS, WS - PERFORMANCE AWARD/QSI
RECOMMENDATIONS
SES - AWARD, BONUS/
PERCENT OF SALARY ( INCLUDES Locality Pay)
%
(OR)
PERFORMANCE
RATING
SALARY
AWARD - BONUS
AMOUNT
$
SALARY INCREASE
(OR)
QSI (GS with Successful Level 1 Rating Only - minimum of 52 weeks
(1)
(2)
(3)
must have elapsed since last QSI)
RECOMMENDING OFFICIALS
YES
NO
YES
NO
TO (Grade/Step):
RATER
AWARD APPROVED BY
INTERMEDIATE RATER
PERFORMANCE REVIEW BOARD
DATE (YYYYMMDD)
FUND CITE
SENIOR RATER
ES
$
PART IV - DUTY DESCRIPTION (Rater)
DAILY DUTIES AND SCOPE
. Position Description
is correct:
YES
NO
(To include as appropriate: people, equipment, facilities, and dollars)
(DA Form 374)
PART V - VALUES (Rater)
VALUES
BULLET COMMENTS
Loyalty
Duty
Respect
Selfless service
Honor
Integrity
Personal courage
DA FORM 7222, MAR 2010
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.04ES
SENIOR SYSTEM CIVILIAN EVALUATION REPORT
For use of this form, see AR 690-400; the proponent agency is ASA(M&RA).
PART I - ADMINISTRATIVE DATA
a. NAME (Last, First, Middle Initial)
b. POSITION TITLE, PAY PLAN, SERIES AND GRADE
c. ORGANIZATION/INSTALLATION
d. REASON FOR SUBMISSION
ANNUAL
SPECIAL
INTERN
e. PERIOD COVERED (YYYYMMDD)
f. RATED MOS.
g. RATEE COPY (Check one and date)
FROM
THRU
GIVEN TO RATEE
FORWARDED TO RATEE
PART II - AUTHENTICATION
SIGNATURE
DATE (YYYYMMDD)
a. NAME OF RATER
(Last, First, Middle Initial)
GRADE/RANK, ORGANIZATION, DUTY ASSIGNMENT
SIGNATURE
DATE (YYYYMMDD)
b. NAME OF INTERMEDIATE RATER
(Optional)(Last, First, MI)
GRADE/RANK, ORGANIZATION, DUTY ASSIGNMENT
SIGNATURE
DATE (YYYYMMDD)
c. NAME OF SENIOR RATER
(Last, First, Middle Initial)(If used)
GRADE/RANK, ORGANIZATION, DUTY ASSIGNMENT
d. RATEE: I understand my signature does not constitute
SIGNATURE OF RATEE
DATE (YYYYMMDD)
agreement or disagreement with the evaluations of the
Rater and Senior Rater, and merely verifies Part I and Part
IV data.
PART III - PERFORMANCE AWARD/QUALITY STEP INCREASE
a.
b. ST, SL, GM, GS, WS - PERFORMANCE AWARD/QSI
RECOMMENDATIONS
SES - AWARD, BONUS/
PERCENT OF SALARY ( INCLUDES Locality Pay)
%
(OR)
PERFORMANCE
RATING
SALARY
AWARD - BONUS
AMOUNT
$
SALARY INCREASE
(OR)
QSI (GS with Successful Level 1 Rating Only - minimum of 52 weeks
(1)
(2)
(3)
must have elapsed since last QSI)
RECOMMENDING OFFICIALS
YES
NO
YES
NO
TO (Grade/Step):
RATER
AWARD APPROVED BY
INTERMEDIATE RATER
PERFORMANCE REVIEW BOARD
DATE (YYYYMMDD)
FUND CITE
SENIOR RATER
ES
$
PART IV - DUTY DESCRIPTION (Rater)
DAILY DUTIES AND SCOPE
. Position Description
is correct:
YES
NO
(To include as appropriate: people, equipment, facilities, and dollars)
(DA Form 374)
PART V - VALUES (Rater)
VALUES
BULLET COMMENTS
Loyalty
Duty
Respect
Selfless service
Honor
Integrity
Personal courage
DA FORM 7222, MAR 2010
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.04ES
PERIOD COVERED (YYYYMMDD)
RATEE'S NAME
thru
PART VI - PERFORMANCE EVALUATION (Rater)
a. PERFORMANCE DURING THIS RATING PERIOD
Comparison of individual objectives against accomplishments and DA-established performance standards resulted in the following objectives ratings:
Fails 1 or More
Excellence
Success All or
Needs Improvement
Excellence
Obj
75% or More Obj
Excellence
1 or More Obj
25-74% Obj
Includes Excellence in Org Mgt/Ldshp OR EEO/AA
Obj for supv/mgr
Yes
No
b. BULLET EXAMPLES
PART VII - INTERMEDIATE RATER (Optional)
BULLET COMMENTS
PART VIII - SENIOR RATER (if used) or
PART IX - SENIOR RATER (if used)
RATER (no senior rater used)
BULLET COMMENTS (Performance/Potential)
OVERALL PERFORMANCE RATING
1
}
2
SUCCESSFUL
3
4
FAIR
UNSUCCESSFUL
5
(MUST Have Senior
A completed DA Form 7222-1 was received with this
Rater Review)
report and considered in my evaluation and review:
YES
NO (Explain)
APD LC v1.04ES
REVERSE, DA FORM 7222, MAR 2010

Download DA Form 7222 Senior System Civilian Evaluation Report

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How to Fill out DA Form 7222?

Procedural guidelines and additional information can be found in the AR 690-400, Chapter 4302 Total Army Performance Evaluation System, revised on October 16, 1998. DA Form 7222 instructions are as follows:

  1. Part I requires administrative identifying data about the Ratee. This includes their full name, the information on their position, the name of the organization or installation and their MOS. The first part of the form is also used specifying the purpose of the report, marking it as an annual, special or intern appraisal.
  2. Part II is for identifying the rating chain. Each Rater has to provide the following information: their full name; their grade or rank; the organization and duty assignment prior to signing and dating the form. The rated person also signs the second part of the form.
  3. Nominations and approvals of performance-based rewards and QSIs should be indicated in Part III.
  4. Parts IV and V are intended for duty descriptions and bullet comments respectively. Part VI requires specifying whether the DA Form 374 of the Ratee is correct.
  5. The second page of the form should contain the Ratee's name and the covered period in the top line of the form. A performance evaluation and a performance rating should be provided in Part VI. Part VII is filled in by the Intermediate Rater if they took part in the rating chain.
  6. Part VIII is for the overall evaluation of performance. An unsuccessful rating must be accompanied by a review made by a Senior Rater. Part IX is reserved for any comments the Senior Rater may have. This part should indicate whether the supporting DA 7222-1 Form was attached and taken into consideration. A negative answer must be explained.
  7. The document must be signed by the rating chain and the Ratee to be valid.
  8. The completed annual appraisals are prepared in three copies. The original form is kept by the Ratee, one copy should be submitted to the Civilian Personnel Office, and the second copy is kept by the Rater.
  9. In case any mistakes are found on the DA 7222, a new document should be prepared and signed by the appropriate Raters. All of the official copies containing the error should be destroyed.
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