Da Form 67-9-1 - Officer Evaluation Report Support Form (Page 2 of 2) in pdf

c. LIST YOUR SIGNIFICANT CONTRIBUTIONS

SIGNATURE AND DATE

PART V - RATER AND/OR INTERMEDIATE RATER

(Review and comment on Part IVa, b, and c above).

Insure remarks are consistent with your performance and potential evaluation on DA Form 67-9

a. RATER COMMENTS (Optional)

SIGNATURE AND DATE (Mandatory)

b. INTERMEDIATE RATER COMMENTS (Optional)

SIGNATURE AND DATE (Mandatory)

DATA REQUIRED BY THE PRIVACY ACT (U.S.C. 552a)

1. AUTHORITY: Sec 301 Title 5 USC; Sec 3012 Title 10

2. PURPOSE: DA Form 67-9, Officer Evaluation Report, serves as the primary source of information for officer personnel management decisions.

DA Form 67-9-1, Officer Evaluation Support Form, serves as a guide for the rated officer's performance and development, enhances the

accomplishment of the organization mission, and provides additional performance information to the rating chain. DA Form 67-9-1a, Junior Officer

Developmental Support Form, serves as a common framework for Junior Officer Development and standardizes Junior Officer counseling.

3. ROUTINE USE: DA Form 67-9 will be maintained in the rated officer's Official Military Personnel File (OMPF) and Career Management Individual

File (CMIF). A copy will be provided to the rated officer either directly or forwarded to the rated officer. DA Form 67-9-1 and DA Form 67-9-1a are

for organizational use only and will be returned to the rated officer after review by the rating chain.

4. DISCLOSURE: Disclosure of the rated officer's SSN (Part I, DA Form 67-9) is voluntary. However, failure to verify the SSN may result in a

delayed or erroneous processing of the officer's OER. Disclosure of the information in Part IV, DA Form 67-9-1 is voluntary. However, failure to

provide the information requested will result in an evaluation of the rated officer without the benefits of that officer's comments. Should the rated

officer use the Privacy Act as a basis not to provide the information requested in Part IV, the Support Form will contain the rated officer's

statement to that effect and be forwarded through the rating chain in accordance with AR 623-105.

DA FORM 67-9-1, OCT 97 (Reverse)

USAPA V1.01

Da Form 67-9-1 - Officer Evaluation Report Support Form Page 2