Officer Evaluation Report

Download a blank fillable Officer Evaluation Report in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Officer Evaluation Report with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

OFFICER EVALUATION REPORT
FOR OFFICIAL USE ONLY (FOUO)
AR 623-3
For use of this form, see
; the proponent agency is DCS, G-1.
SEE PRIVACY ACT STATEMENT IN AR 623-3.
PART I - ADMINISTRATIVE DATA
DESIGNATED
a. NAME (Last, First, Middle Initial)
b. SSN
c. RANK
d. DATE OF RANK
(YYYYMMDD)
e. BRANCH
/
PMOS (W0)
f.
SPECIALTIES
g.1. UNIT, ORG., STATION, ZIP CODE OR APO, MAJOR COMMAND
g.2. STATUS CODE
h. REASON FOR SUBMISSION
j. RATED
k. NONRATED
l. NO. OF
i. PERIOD COVERED
m. RATED OFFICER'S AKO EMAIL ADDRESS
n. UIC
o. CMD
p. PSB
MONTHS
CODES
ENCL
(.gov or mil)
CODE
CODE
FROM (YYYYMMDD)
THRU (YYYYMMDD)
PART II - AUTHENTICATION (Rated officer's signature verifies officer has seen completed OER Parts I-VII and the admin data is correct)
a. NAME OF RATER (Last, First, MI)
RANK
SSN
POSITION
SIGNATURE
DATE (YYYYMMDD)
b. NAME OF INTERMEDIATE RATER (Last, First, MI)
RANK
SSN
POSITION
SIGNATURE
DATE (YYYYMMDD)
RANK
c. NAME OF SENIOR RATER (Last, First, MI)
SSN
POSITION
SIGNATURE
DATE (YYYYMMDD)
BRANCH
E-MAIL ADDRESS (.gov or .mil)
SENIOR RATER'S ORGANIZATION
SENIOR RATER TELEPHONE NUMBER
e. SIGNATURE OF RATED OFFICER
DATE (YYYYMMDD)
d. This is a referred report, do you wish to make comments?
No
Yes, comments are attached
PART III - DUTY DESCRIPTION
a. PRINCIPAL DUTY TITLE
b. POSITION AOC/BR
c. SIGNIFICANT DUTIES AND RESPONSIBILITIES. REFER TO PART IVa, DA FORM 67-9-1.
PART IV - PERFORMANCE EVALUATION - PROFESSIONALISM (Rater)
CHARACTER
Disposition of the leader: combination of values, attributes, and skills affecting leader actions
a.
ARMY VALUES
(Comments mandatory for all "NO" entries. Use PART Vb.)
Yes No
Yes No
1. HONOR:
5. RESPECT:
Promotes dignity, consideration, fairness, & EO
Adherence to the Army's publicly declared code of values
2. INTEGRITY:
6. SELFLESS-SERVICE:
Possesses high personal moral standards; honest in word and deed
Places Army priorities before self
3. COURAGE:
7. DUTY:
Manifests physical and moral bravery
Fulfills professional, legal, and moral obligations
4. LOYALTY:
Bears true faith and allegiance to the U.S. Constitution, the Army, the unit, and the soldier
b. LEADER ATTRIBUTES / SKILLS / ACTIONS:
First, mark "YES" or "NO" for each block. Second, choose a total of six that best describe the rated officer. Select one from
ATTRIBUTES, two from SKILLS (Competence), and three from ACTIONS (LEADERSHIP). Place an "X" in the appropriate numbered box with optional comments in PART Vb.
Comments are mandatory in Part Vb for all "No" entries.
MENTAL
PHYSICAL
EMOTIONAL
b . 1 . ATTRIBUTES (Select 1)
1.
2 .
3.
Fundamental qualities and
Possesses desire, will, initiative, and discipline
Maintains appropriate level of physical
Displays self-control; calm under pressure
characteristics
fitness and military bearing
CONCEPTUAL
INTERPERSONAL
TECHNICAL
b.2 SKILLS (Competence)
1.
2.
3.
Demonstrates sound judgment, critical/creative
Shows skill with people: coaching, teaching,
Possesses the necessary expertise to
(Select 2)
thinking, moral reasoning
counseling, motivating and empowering
accomplish all tasks and functions
Skill development is part of self-
development; prerequisite to action
4. TACTICAL
Demonstrates proficiency in required professional knowledge, judgment, and warfighting
b.3. ACTIONS (LEADERSHIP) (Select 3) Major activities leaders perform: influencing, operating, and improving
COMMUNICATING
DECISION-MAKING
MOTIVATING
INFLUENCING
1.
2.
3.
Method of reaching goals while
Displays good oral, written, and listening skills for
Employs sound judgment, logical reasoning
Inspires, motivates, and guides others toward
operating / improving
individuals / groups
and uses resources wisely
mission accomplishment
PLANNING
EXECUTING
ASSESSING
OPERATING
4.
5.
6.
Short-term mission
Develops detailed, executable plans that are
Shows tactical proficiency, meets mission
Uses after-action and evaluation tools to
accomplishment
feasible, acceptable, and suitable
standards, and takes care of people/resources
facilitate consistent improvement
DEVELOPING
7.
BUILDING
LEARNING
IMPROVING
8.
9.
Long-term improvement in the Army
Invests adequate time and effort to develop
Spends time and resources improving teams,
Seeks self-improvement and organizational
its people and organizations
individual subordinates as leaders
groups and units; fosters ethical climate
growth; envisioning, adapting and leading change
c. APFT:
DATE:
HEIGHT:
WEIGHT:
d. OFFICER DEVELOPMENT - MANDATORY YES OR NO ENTRY FOR RATERS OF CPTs, LTs, CW2s, AND WO1s.
WERE DEVELOPMENTAL TASKS RECORDED ON DA FORM 67-9-1a AND QUARTERLY FOLLOW-UP COUNSELINGS CONDUCTED?
Page 1 of 2
DA FORM 67-9, OCT 2011
PREVIOUS EDITIONS ARE OBSOLETE.
APD PE v1.01ES

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go
Page of 2