Top Banner
/ M/f NCO EVALUATION REPORT For use of this form, see AR 623-205; the proponent agency is ODCSPER SEE PRIVACY ACT STATEMENT . IN AR 623-205. APPENDIX C. T PART I - ADMINISTRATIVE DATA a NAME (Last. First. Middle Initial) NliWMAN, JEREMY A f UNIT, ORG . STATION, ZIP CODE OR APO, MAJOR COMMAND HWB, 1/3 ACR, FT CARSON, CO 80913 FORSCOM b. SSN 571-75-6939 RANK SGT h. PERIOD COVERED FROM YYYY MM 2005 12 THRU YYYY MM 2006 07 i RATED MONTHS 08 j NON- RATED CODES k NO OF ENCL & d. DATE OF RANK 051201 PMOSC 13S20 I RATED NCO COPY (Check one and Date) g. REASON FOR SUBMISSION 3 | CHANGE OF RATER 1 Given to NCO a 2. Forwarded to NCO Dare JUL 1 7 2006 m PSC Initials n CMD CODE FC o PSB CODE FS13 PART II • AUTHENTICATION a NAME OF RATER (Last. First, Middle Initial) BOONE,-ROBERT L SSN 522-23-9091 SIGNATURE RANK. PMOSC/BRANCH, ORGANIZATION, DUTY ASSIGNMENT SFC, 13B48, HWB, 1/3 ACR, FT CARSON, CO 80913 PLATOON SERGEANT DATE JUL 1 7 2006 b. NAME OF SENIOR RATER (Last. First, Middle Initial) FELIX, LLOYD A SSN 330-68-6134 SIGNATURE RANK, PMOSC/BRANCH, ORGANIZATION, DUTY ASSIGNMENT ^^ ^*^ DATE CPT, MI, HWB, 1/3 ACR, FT CARSON, CO 80913 EXECUTIVE OFFICER______________________________JUL 1 7 W% evaluations of the rater and senior rater I further understand my signature verifies thafthe administrative data in Part I. the rating officials in Part It. the duly description to include the counseling dates in Part IN. and the APFT ana height/weight entries in Pan IVc are correct. I have seen the report completed through Part v. except Parts lid and lie. ram aware of the appeals process of AR 623-205 DATE JUL 1 7 2006 d NAME OF REVIEWER (Last. First. Middle Initial) WOODS, KENNETH T. SSN 246-43-4414 RANK, PMOSC/BRANCH, ORGANIZATION. DUTY ASSIGNMENT CPT, FA, HWB, 1/3 ACR, FT CARSON, CO 80913 BATTERY COMMANDER DATE JUL 1 7 2006 e ^ CONCUR WITH RATER AND SENIOR RATER EVALUATIONS Q NONCONCUR WITH RATER AND/OR SENIOR RATER EVAL (See attached comments) PART til • DUTY DESCRIPTION (Rater) a PRINCIPAL DUTY TITLE Nuclear, Biological and Chemical Operations NCOIC b. DUTYMOSC 74D20 c. DAILY DUTIES AND SCOPE (To include, as appropriate, people, equipment, facilities and dollars) Nuclear, Biological and Chemical Operations NCOIC in a M109A6 Paladin Howitzer Battery in a world wide deployable Armored Cavalry Regiment; responsible for training 150 personnel on proper usage and maintenance of radiation, chemical agent and biological agent detectors and alarms, individual protective equipment, and decontamination apparati; responsible for assembling and training contamination reconnaissance teams; responsible for advising the chain of command on operations under contaminated conditions; responsible for maintenance, calibration and accountability of equipment valued in excess of $3,000,000_______________________ d AREAS OF SPECIAL EMPHASIS operations during OIF 04-06; battle tracking; small arms; preparation for TOA; redeployment from OIF 04-06; APFT Rater: robert.boonel^,; S/R: lloyd.felix@; Rev: kenneth.t.woods®__________________________________ e APPOINTED DUTIES Calibrations NCOIC; Battery Historian; Armorer; Training NCO; Schools NCO; Sensing NCO f COUNSELING DATES INITIAL 051203 LATER 060301 LATER 060605 LATER PART IV - ARMY VALUES/ATTRIBUTESfSKILLS/ACTIONS (Rater) a. ARMY VALUES. Check either "YES" Or "NO". Comments are mandatory for "No" entries; optional for "Yes" entries.) V A Loyalty Duty Respect Selfless-Service u Honor Integrity Personal Courage )A FORM 2166-8, OCT 2001 1 LOYALTY Bears true faith and allegiance to the U. S. Constitution, the Army, the unit, and other soldiers. 2 DUTY- Fulfills their obligations. 3. RESPECT/EO/EEQ: Treats people as they should be treated 4. SELFLESS-SERVICE: Puts the welfare of the nation, the Army, and subordinates before their own. 5. HONOR: Lives up to all the Army values. 6. INTEGRITY- Does what is right - legally and morally. 7 PERSONAL COURAGE: Faces fear, danger, or adversity (physical and moral) YES X J& X NO Bullet comments o always put the Army, the mission and the interests of Soldiers above his own o dedicated to excellence and a role model of honor o integrity beyond reproach REPLACES DA FORM 2166-7 ,SEP 87. WHICH IS OBSOLE1 b APDI-'b I L'l
2
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: Ncoer

/ M/fNCO EVALUATION REPORT

For use of this form, see AR 623-205; the proponent agency is ODCSPERSEE PRIVACY ACT STATEMENT .IN AR 623-205. APPENDIX C. T

PART I - ADMINISTRATIVE DATAa NAME (Last. First. Middle Initial)NliWMAN, JEREMY Af UNIT, ORG . STATION, ZIP CODE OR APO, MAJOR COMMANDHWB, 1/3 ACR, FT CARSON, CO 80913 FORSCOM

b. SSN571-75-6939

RANK

SGT

h. PERIOD COVEREDFROM

YYYY MM2005 12

THRUYYYY MM2006 07

i RATEDMONTHS

08

j NON-RATEDCODES

k NO OFENCL

&

d. DATE OF RANK

051201PMOSC

13S20

I RATED NCO COPY (Check one and Date)

g. REASON FOR SUBMISSION3 | CHANGE OF RATER

1 Given to NCO

a 2. Forwarded to NCO

Dare

JUL 1 7 2006

m PSCInitials

n CMDCODE

FC

o PSBCODE

FS13

PART II • AUTHENTICATIONa NAME OF RATER (Last. First, Middle Initial)BOONE,-ROBERT L

SSN522-23-9091

SIGNATURE

RANK. PMOSC/BRANCH, ORGANIZATION, DUTY ASSIGNMENTSFC, 13B48, HWB, 1/3 ACR, FT CARSON, CO 80913 PLATOON SERGEANT

DATE

JUL 1 7 2006b. NAME OF SENIOR RATER (Last. First, Middle Initial)FELIX, LLOYD A

SSN330-68-6134

SIGNATURE

RANK, PMOSC/BRANCH, ORGANIZATION, DUTY ASSIGNMENT ^^ ^*^ DATECPT, MI, HWB, 1/3 ACR, FT CARSON, CO 80913 EXECUTIVE OFFICER______________________________JUL 1 7 W%evaluations of the rater and senior rater I further understand my signature verifies thafthe administrativedata in Part I. the rating officials in Part It. the duly description to include the counseling dates in Part IN. andthe APFT ana height/weight entries in Pan IVc are correct. I have seen the report completed through Part v.except Parts lid and lie. ram aware of the appeals process of AR 623-205

DATE

JUL 1 7 2006d NAME OF REVIEWER (Last. First. Middle Initial)WOODS, KENNETH T.

SSN246-43-4414

RANK, PMOSC/BRANCH, ORGANIZATION. DUTY ASSIGNMENTCPT, FA, HWB, 1/3 ACR, FT CARSON, CO 80913 BATTERY COMMANDER

DATE

JUL 1 7 2006e ^ CONCUR WITH RATER AND SENIOR RATER EVALUATIONS Q NONCONCUR WITH RATER AND/OR SENIOR RATER EVAL (See attached comments)

PART til • DUTY DESCRIPTION (Rater)a PRINCIPAL DUTY TITLE

Nuclear, Biological and Chemical Operations NCOICb. DUTYMOSC74D20

c. DAILY DUTIES AND SCOPE (To include, as appropriate, people, equipment, facilities and dollars)Nuclear, Biological and Chemical Operations NCOIC in a M109A6 Paladin Howitzer Battery in a world wide deployable ArmoredCavalry Regiment; responsible for training 150 personnel on proper usage and maintenance of radiation, chemical agent and biologicalagent detectors and alarms, individual protective equipment, and decontamination apparati; responsible for assembling and trainingcontamination reconnaissance teams; responsible for advising the chain of command on operations under contaminated conditions;responsible for maintenance, calibration and accountability of equipment valued in excess of $3,000,000_______________________d AREAS OF SPECIAL EMPHASISoperations during OIF 04-06; battle tracking; small arms; preparation for TOA; redeployment from OIF 04-06; APFTRater: robert.boonel^,; S/R: lloyd.felix@; Rev: kenneth.t.woods®__________________________________e APPOINTED DUTIESCalibrations NCOIC; Battery Historian; Armorer; Training NCO; Schools NCO; Sensing NCOf COUNSELING DATES INITIAL

051203LATER

060301LATER

060605LATER

PART IV - ARMY VALUES/ATTRIBUTESfSKILLS/ACTIONS (Rater)a. ARMY VALUES. Check either "YES" Or "NO". Comments are mandatory for "No" entries; optional for "Yes" entries.)

VA

LoyaltyDuty

RespectSelfless-Service

uHonor

IntegrityPersonal Courage

)A FORM 2166-8, OCT 2001

1 LOYALTY Bears true faith and allegiance to the U. S. Constitution, the Army, the unit, and other soldiers.2 DUTY- Fulfills their obligations.3. RESPECT/EO/EEQ: Treats people as they should be treated4. SELFLESS-SERVICE: Puts the welfare of the nation, the Army, and subordinates before their own.5. HONOR: Lives up to all the Army values.6. INTEGRITY- Does what is right - legally and morally.7 PERSONAL COURAGE: Faces fear, danger, or adversity (physical and moral)

YES

X

J&

X

NO

Bullet comments

o always put the Army, the mission and the interests of Soldiers above his owno dedicated to excellence and a role model of honoro integrity beyond reproach

REPLACES DA FORM 2166-7 ,SEP 87. WHICH IS OBSOLE1 bAPDI-'b I L'l

Page 2: Ncoer

RATED NCO'S NAME (Last, First. Middle Initial)+

NEWMAN, JEREMY A jeremy.a.newman@SSN

571-75-6939THRU DATE

2006 07 +PART IV fRaferl- VALUES/NCO RESPONSIRII ITIFS speaiic Uuiiel examples 01 txt-fctLt/vt-t' or Httun iMHHUVtMkNl Ӗ are mandatory.Specific Bullet examples of 'SUCCESS' are optional.b. COMPETENCEo Duty proficiency; MOS competencyo Technical & tactical; knowledge, skills, andabilitieso Sound judgmento Seeking self-improvement; always learningo Accomplishing tasks to the fullest capacity;committed to excellence

EXCELLENCE. SUCCESS NEEDS IMPROVEMENT(Exceeds std) (Meets std) (Some) (Muchiw • n___n . nc. PHYSICAL FITNESS & MILITARY BEARING

o selected above peers to serve as NBC NCOIC and Battery Operations NCO duringcombat operations

o continually displayed sound judgment under stressful combat conditions, enablingthe Battery to successfully complete all missionso possesses a wide breadth of knowledge that enabled him to accomplish any missionassigned above standard

o Mental and physical toughnesso Endurance and stamina to go the distanceo Displaying confidence and enthusiasm;looks like a soldier

EXCELLENCE SUCCESS NEEDS IMPROVEMENT(Exceeds std) (Meets std) (Some) (Much)

APFT PASS 0512 HEIGHT/WEIGHT 74/235 yES0 maintains high state of personal appearance and mental toughness0 displays energy and vitality in performing daily responsibilities0 projects self confidence, authority and enthusiasm

d. LEADERSHIP0 Mission first.0 Genuine concern for soldiers0 Instilling the spirit to achieve and win0 Setting the example; Be, Know, Do

EXCELLENCE SUCCESS NEEDS IMPROVEMENT(Exceeds std) (Meets std) (Some) (Much)n 53 n

0 exhibited a genuine concern for the welfare of Soliders, taking personal time to helpmentor and counsel those who needed guidanceo constantly puts forth maximum effort in every endeavor, a strength that has allowedthe unit and platoon to succeed during redeployment0 able to utilize a vast array of resources and draw upon civilian experience toenhance both the mission effectiveness of himself and the Soldiers around hime. TRAINING

0 Individual and teamo Mission focused; performance orientedo Teaching soldiers how; common tasks,duty-related skills0 Sharing knowledge and experience to fight,survive and win

EXCELLENCE SUCCESS NEEDS IMPROVEMENT(Exceeds std) (Meets std) (Some) (Much)M_______Ӛ________Q

o trained incoming personnel from 1st Armored Division during transfer of authorityon combat operations in the Tactical Operation Center at FOB Al Nimr, Iraq0 ensured Battery was properly trained in the usage of Nuclear, Biological andChemical Individual Protective Equipment

0 conducted training for the unit on usage, maintenance and inspection of crew servedand individual weapons with outstanding results______• __________________f. RESPONSIBILITY & ACCOUNTABILITY,,o Care and maintenance of equipment/facilitieso Soldier and equipment safety0 Conservation of supplies and fundso Encouraging soldiers to learn and grow0 Responsible for good, bad, right & wrongEXCELLENCE SUCCESS NEEDS IMPROVEMENT(Exceeds std) (Meets std) (Some) (Much)

1*1 n n n

0 maintained 100% accountability of units sensitive items and NBC equipment valuedin excess of 53,000,000 . .

0 developed an extensive maintenance program on crew serve and individual weaponsthat assisted the Battery in maintaining a high level of combat power at all timeso assumes responsibility of his actions and those of his subordinates regardless ofthe consequence and without hesitation

PART V - OVERALL PERFORMANCE AND POTENTIALa. RATER. Overall potential for promotion and/orservice Jn positions of greater responsibility.AMONG FULLYTHE BEST CAPABLE MARGINALM.

b. RATER. List 3 positions in which the ratedNCO could best serve the Army at his/hercurrent or next higher grade.

Instructor__________________________Drill Sergeant_______________________Observer/ Controller

c. SENIOR RATER. Overall performance

+

e. SENIOR RATER BULLET COMMENTS0 promote ahead of peers0 send to BNCOC immediately

0 possesses unlimited potential for positions of higher authority; an asset to any unitassigned

E12 3 4 5Successful Fair Poor

DA FORM 2166-8, OCT2001

d. SENIOR RATER. Overall potentialfor promotion and/or service inpositions of greater responsibility.

nr^r

12 3 4 5Superior Fair Poor

APOPEvl.01