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Af Form 860A PDF Details

The Department of the Army recently released a new form, the AF Form 860A. This new form is used to report adverse administrative actions, known as DA casestates. This form will be used to provide information on the status of individuals who are subject to an adverse action and will replace the DD Form 214. The AF Form 860A is required for all soldiers and must be submitted within 10 days of any event that results in an adverse action. The form can be found on the MyArmyBenefits website.

If you would like first find out how much time you need to complete the af form 860a and the number of pages it has, here's some basic information that may be useful.

Question	Answer
Form Name	Af Form 860A
Form Length	2 pages
Fillable?	Yes
Fillable fields	52
Avg. time to fill out	10 min 58 sec
Other names	form 860a form, af 860a, af 860a pdf, af form 860a template

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CIVILIAN RATING OF RECORD

(Please read Privacy Act Statement on reverse before completing this form.)

EMPLOYEE(Last Name, First, Middle Initial)			SSN	ORGANIZATION		PAY PLAN	SERIES	GRADE/STEP	TOTAL BASE, LOCALITY AND
									OTHER SUPPLEMENTAL PAY
PUBLIC, JOHN Q			0000	51 FSS/FSMC		GS	0201	12/05	$58,376 PA

APPRAISAL PERIOD	FROM:	20130401		TO:	20140331			EFFECTIVE DATE:		20140601

- Part A normally contains one to seven critical elements.

- Rate the critical element(s) in Part A by placing an "X" in the appropriate block (s). The overall performance rating is derived from the ratings of the critical elements. A rating of "Does not meet" on any critical element results in a determination that overall performance is unacceptable. An Unacceptable rating is the basis for initiating a performance improvement plan and requires proper documentation. Contact the Civilian Personnel Flight for assistance.

- Complete Part B, "Impact on Mission Accomplishment" for GS-14s and GS-15s (bullet format, limited to 9 lines) . Optional to complete for others. - Complete Part C, "Award Justification" for those being recommended for an award (bullet format, limited to 9 lines).

PART A. Position Requirements. (Was the employee's performance Unacceptable or Acceptable on the Performance Plan's critical elements?)

DOES NOT MEET

MEETS

DOES NOT MEET

MEETS

ELEMENT 1

ELEMENT 8

ELEMENT 2

ELEMENT 9

ELEMENT 3

ELEMENT 10

ELEMENT 4

ELEMENT 11

ELEMENT 5

ELEMENT 12

ELEMENT 6

ELEMENT 13

ELEMENT 7

ELEMENT 14

OVERALL PERFORMANCE RATING R - ACCEPTABLE: Rated "Meets Standards" on all critical elements.

RN - UNACCEPTABLE: Rated "Does Not Meet Standards" on one or more critical elements

PART B. Impact on Mission Accomplishment. (Mandatory completion required for GS-14s/15s.)

N/A

PART C. Award Justification. (Part B may serve as Part C award justification.)

-UP TO 9 LINES

-BULLET FORMAT

If you do Not nominate for an award, leave this Part C blank.

PART D. Performance Award.

AWARD(Enter "P" - Performance or "Q" - QSI)

AWARD PERCENTAGE OR AMOUNT (If P (cash), enter as a percentage, e.g., 1.5, or as a whole dollar amount)

$250.00

OTHER AWARD (For Time-Off Awards, state number of hours) (Example: TOA (40 Hrs)

Certification for Time-Off Award (as applicable) : I have considered fully the wage costs and productivity loss in granting this time-off award. The amount of time-off granted is commensurate with the individual's contribution or accomplishment. I also considered the unit's workload and unit employees' leave projections and certify that the employee can schedule the time-off award in addition to other scheduled leave. I also considered other available forms of recognition in determining the amount of this time-off award. Note: Ensure the number of time-off award hours previously awarded to this employee this leave year plus this award does not exceed 80 hours.

PART E. Certification. (Certify by having rater, reviewer, award approving official (if required), and employee sign and date this form.)

RATER	DUTY PHONE	DATE (YYYYMMDD)
	(784) 670-0

REVIEWER	DUTY PHONE	DATE (YYYYMMDD)
	(784) 440-2

AWARD APPROVING OFFICIAL	DUTY PHONE	DATE (YYYYMMDD)

EMPLOYEE (Receipt acknowledged. Signature does not indicate agreement or disagreement.)

DATE (YYYYMMDD)

AF FORM 860A, 19990701, V3

PREVIOUS EDITIONS ARE OBSOLETE

PART F. Civilian Promotion Appraisal.

This appraisal is used for competitive in service placement actions, including promotions, reassignments or demotions to positions with known growth potential, and other such instances. The ratings on this form are used as a sort factor in determining final rank order of employees having substantially equal knowledge, skills and abilities, when the number of candidates exceeds the number of employees who can be referred to the selecting official for consideration.

APPRAISAL FACTORS - MANNER OF PERFORMANCE (Do not complete if employee is a GS-15)

Appraisal factors listed below represent work behaviors that can be observed in the context of the employee's current position and are considered predictive of performance at the next higher level. Based on your observations of the employee's performance, rate EVERY appraisal factor. Use the following scale in making the ratings. Place the number (1-9) in the block preceding the factor.

	LOW RANGE		CENTRAL RANGE		HIGH RANGE
1.	Very Poor	4.	Slightly Below Fully Successful	7.	Above Fully Successful
2.	Far Below Fully Successful	5.	Fully Successful	8.	Far Above Fully Successful
3.	Below Fully Successful	6.	Slightly Above Fully Successful	9.	Outstanding

1. WORK EFFORT:

Exerts effort and shows initiative in starting, carrying out and completing tasks; spends time effectively performing work.

2. ADAPTABILITY TO WORK:

Picks up new ideas and procedures quickly; is easy to instruct; can adapt to the demands of new situations; understands and carries out oral or written instructions.

3. PROBLEM SOLVING:

Devises effective solutions to problems or identifies effective methods and procedures for accomplishing objectives.

4. WORKING RELATIONSHIPS:

Sensitive to the behavior of fellow workers, supervisors and subordinates; maintains effective working relationships with others.

5. COMMUNICATION:

Communicates clearly and effectively, whether orally or in writing.

6. WORK PRODUCTIVITY:

Productive during work time; completes his/her work projects, duties and tasks in a timely manner.

7. SELF-SUFFICIENCY:

Works independently with little need for additional supervision or help; follows through well; accomplishes all tasks required to complete a job on his/her own.

8. SKILL IN WORK:

Performs job-associated tasks well, whether they require physical, technical, professional, supervisory or managerial skills, is considered very skillful on the job.

9. WORK MANAGEMENT:

Effectively plans and organizes work; properly follows or implements management procedures, directives, regulations, or technical orders; ability to direct or evaluate or substitute for absent supervisor.

PRIVACY ACT STATEMENT

Authority: 10 U.S.C. 8013 and Executive Order 9397.

Purpose: The social security number is needed to correctly identify the employee.

Routine Use: This information may be disclosed to another agency if the employee transfers to another agency.

Disclosure is Voluntary: However, without it, it may affect the ability to accurately identify the employee and the records.

AF FORM 860A, 19990701, V3 (REVERSE)

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Provide the appropriate data in each part to complete the PDF af form 860, a template

Write down the demanded information in AWARD (Enter "P" - Performance or, AWARD PERCENTAGE OR AMOUNT (If P, OTHER AWARD (For Time, Off Awards, Certification for Time, Off Award, Note: Ensure the number of, : I have considered fully the wage, PART E, RATE, R REVIEWER, DUTY PHONE (784) 670, 0 DUTY PHONE (784) 440, 2 DATE YYYY, MM, DD DATE, YYYY, MM, DD and AWARD APPROVING OFFICIAL segment.

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Af Form 860A – Fill Out and Use This PDF

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