Form Navpers 1616 27 – Fill Out and Use This PDF

1. Name

(Last, First MI Suffix)

2. Grade/Rate

3.

Desig

4.

SSN

5.

ACT

FTS

INACT

AT/ADSW/265

6. UIC

7. Ship/Station

8. Promotion Status

9. Date Reported

Occasion for Report

Detachment

Detachment of

Period of Report

10.

Periodic

11.

of Individual

12. Reporting Senior

13.

Special

14.

From:

15.

To:

16.

Not Observed

Type of Report

20.

Physical Readiness

21.

Billet Subcategory (if any)

Report

17. Regular

18.

Concurrent

19.

Ops Cdr

22.

Reporting Senior

(Last, FI

MI)

23. Grade

24. Desig

25. Title

26. UIC

27.

SSN

PERFORMANCE TRAITS: 1.0 – Below standards / not progressing or UNSAT in any one standard; 2.0 – Does not yet meet all 3.0 standards;

3.0 – Meets all 3.0

standards; 4.0 – Exceeds most 3.0 standards;

5.0 – Meets overall criteria and most of the specific standards for 5.0. Standards are not all inclusive.

PERFORMANCE

1.0*

2.0

3.0

4.0

5.0

Pro-

Above

TRAITS

Below Standards

Meets Standards

Greatly Exceeds Standards

gressing

Standards

33.

- Neglects growth/development or welfare

- Effectively stimulates growth/development in

- Inspiring motivator and trainer. Junior

DECKPLATE

of Junior Officer and Enlisted Sailors.

Junior Officers and Enlisted Sailors.

Officers and Enlisted Sailors reach highest

LEADERSHIP:

level of growth and development.

- Organizing,

- Presence not felt on the deckplates.

- Visible and engaged on the deckplate; sets

- Always visible and engaged on the deckplate;

motivating and

positive tone.

energetically sets positive tone across CMD.

developing others to

- Does not set or achieve goals relevant to

- Sets/achieves useful, realistic goals that

- Leadership achievements dramatically

accomplish goals.

command mission and vision.

support command mission.

further command mission and vision.

- Engaging and

- Does not tailor leadership style to

- Tailors leadership to situation to accomplish

- Seamlessly tailors leadership to each Sailor’s

visible presence

situation or individual.

mission.

strengths, weaknesses and goals to maximize

establishes positive

mission effectiveness.

tone for command.

- Fails to organize, creates problems for

- Organizes successfully, implementing process

- Superb organizer, great foresight, develops

subordinates.

improvements and efficiencies.

process improvements and efficiencies.

NOB

- Lacks ability to manage under

- Performs well in stressful situations.

- Perseveres through the toughest

stress.

challenges and inspires others.

34.

- Lacks basic Navy knowledge.

- Has thorough knowledge of Navy

- Navy Expert, complete understanding of

INSTITUTIONAL

organization and structure.

purpose, organization, and structure.

AND TECHNICAL

- Unaware and unwilling to learn details of

- Has thorough knowledge of Navy programs

- Detailed, current knowledge and strong

EXPERTISE:

Navy programs and policies.

and policies.

advocate for all Navy programs and policies.

- Institutional, policy

- Lacks basic professional knowledge to

- Has detailed rating knowledge; resolves

- Recognized expert, sought after to solve

and technical

perform effectively.

technical issues within rating.

difficult problems, executes innovative ideas.

knowledge.

- Cannot apply basic skills.

- Competently performs both routine and new

- Exceptionally skilled; complete accuracy and

- Practical application,

tasks.

precision in all technical actions, duties and

procedural

- Tactical knowledge and skill in specialty

- Tactical knowledge and skill in specialty

procedures.

compliance.

are below standards compared to

equal to others of same rank and

- Tactical knowledge and skill in

NOB

others of same rank and experience.

experience.

command mission and function.

35.

- Fails to uphold and enforce standards.

- Actively teaches, upholds and enforces

- Proactively teaches, upholds, and enforces

PROFESSIONALISM:

standards with peers and subordinates.

standards throughout the command.

- Standard enforcement;

- Does not effectively utilize the Chief’s

- Participates in command planning and

- Actively leads command activities, solves

taking initiative,

Mess to plan and solve challenges.

problem solving through the Chief’s Mess.

command challenges, and drives mission

planning/prioritizing/

- Improvement of peers, subordinates, and

- Committed to professional education/training

accomplishment through the Chief’s Mess.

solving challenges in

- Fosters an environment of improvement,

Chief’s Mess.

self not a priority.

for self and subordinates.

education and professional development.

- Continuous learning;

- Unable to meet one or more physical

- A leader in physical readiness.

Standards of appearance,

readiness standards.

- Complies with physical readiness program.

- Exemplary personal appearance and

conduct, physical fitness,

- Consistently unsatisfactory appearance or

- Excellent personal appearance and

representative of the Navy.

qualifications.

unsatisfactory demeanor or conduct.

representative of the Navy.

- Team builder, inspires cooperation and focus

- Creates conflict, unwilling to work with

- Reinforces others’ efforts, meets personal

on mission accomplishment; leverages

NOB

others, puts self above team.

commitments to team.

talents of all Sailors.

36.

- Does not consistently demonstrate loyalty

- Loyal to mission, seniors, peers and

- Loyal to mission, seniors, peers and

LOYALTY:

to mission, seniors, peers or subordinates.

subordinates; moral courage to raise issues

subordinates; moral courage to raise issues

- Loyalty to mission,

and support the outcome.

and strength to fully support the outcome.

seniors, peers and

- Not concerned about Sailor success.

- Effective mentor, actions adequately

- Exemplary mentor, creates environment with

subordinates.

encourage/support subordinates’

outstanding professional growth

- Dedication to Sailor

personal/professional growth.

opportunities for each Sailor.

success, Sailor

- Allows command challenges to impact

- Routinely solves command challenges before

- Proactively identifies and solves command

advocacy.

Sailor readiness.

they significantly impact Sailor

challenges before they impact Sailor

NOB

readiness.

readiness.

NAVPERS 1616/27 (8-10)

FOR OFFICIAL USE ONLY-PRIVACY ACT SENSITIVE.

PERFORMANCE

1.0*

2.0

3.0

4.0

5.0

Pro-

Above

TRAITS

Below Standards

Meets Standards

Greatly Exceeds Standards

gressing

Standards

37.

- Demonstrates exclusionary behavior, fails

- Diversity: values differences as strengths,

- Seamlessly integrates diversity into all

CHARACTER:

to value differences from cultural

fosters atmosphere of acceptance/inclusion per

aspects of the command.

- Integrity, adherence to

diversity.

EO/EEO policy.

- Model of achievement. Develops unit

Navy Core Values.

- Lacks personal integrity and does not take

- Trustworthy, ethical and honest.

cohesion by valuing differences as strengths.

-Recognition of Diversity.

responsibility for actions or decisions.

- Always lives up to Navy Core Values: Honor,

- Leads with an uncompromising code of

- Contributes to growth,

- Fails to live up to Navy Core Values:

Courage and Commitment.

integrity.

human worth and

Honor, Courage and Commitment.

- Exemplifies Navy Core Values: Honor,

community.

NOB

Courage and Commitment.

38.

- Stifles information exchange, idea

- Facilitates information exchange, idea sharing

- Actively facilitates information exchange,

ACTIVE

sharing and diversity of opinion.

and diversity of opinion.

idea sharing and diversity of opinion.

COMMUNICATION:

- Does not take advantage of the Chief’s

- Uses Chief’s Mess as an open forum to

- Actively uses Chief’s Mess as an open

- Communication,

Mess to discuss, plan, or act on command

discuss, plan, and act on command issues.

forum to discuss, plan, and act on command

questioning attitude,

issues.

issues.

energized information

- Poor communicator; actions negatively

- Effectively communicates and listens to

- Energizes communication flow up and down

flow.

impact mission goals and readiness.

subordinates, peers, and seniors.

the chain of command.

NOB

39.

- Lacks knowledge and understanding of

- Good understanding of naval customs and

- Thorough understanding of naval customs

SENSE OF

naval customs and traditions.

traditions.

and traditions.

HERITAGE:

- Ignores naval traditions, customs, and

- Integrates naval traditions, customs, and

- Proactively integrates naval traditions,

- Know and teach

practices when considering decisions, in

practices into decision making processes,

customs, and practices into decision making

customs and traditions,

training, or in daily leadership.

training and daily leadership.

processes, training and daily leadership.

understand naval history.

- No grasp of naval history.

- Occasionally uses naval history to

- Consistently uses naval history to

demonstrate who we are as a service.

demonstrate who we are as a service.

NOB

40. I recommend screening this individual for next career milestone(s) as follows: (Maximum of two)

Recommendations may be for competitive schools or duty assignments such as LCPO, DEPT CPO, SEA, CMC

41. COMMENTS ON PERFORMANCE. *All 1.0 marks, three 2.0 marks, and 2.0 marks in Block 37 must be specifically substantiated in comments. Comments must be verifiable.

Font

10

Font must be 10 or 12 pitch (10 to 12 point) only. Use upper and lower case.

Promotion

NOB

Significant

Progressing

Promotable

Must

Early

44. Reporting Senior Address

Recommendation

Problems

Promote

Promote

42.

INDIVIDUAL

43.

SUMMARY

45. Signature of Reporting Senior

46.

Signature of individual evaluated. “I have seen this report, been apprised of my

performance, and understand my right to make a statement.”

Date:

I intend to submit a statement

do not intend to submit a statement

Date:

Member Trait Average:

Summary Group Average:

NAVPERS 1616/27 (8-10)

FOR OFFICIAL USE ONLY-PRIVACY ACT SENSITIVE.