Blank 5164 R PDF Template

1. What is the DA Form 5164-R used for?

   The DA Form 5164-R, commonly known as the "Hands-On Evaluation" form, is a document utilized within the United States Army. Its primary use is for assessing a soldier's performance in specific tasks. This form allows evaluators to record whether a soldier has successfully completed a task (PASS) or has failed to meet the required standards (FAIL). These evaluations are crucial for tracking progress, identifying areas for improvement, and ensuring that all personnel maintain the necessary skills for their roles.

2. Who is responsible for completing the DA Form 5164-R?

   Evaluators, typically superior officers or appointed personnel within the training department, are responsible for completing the DA Form 5164-R. They observe each soldier performing the designated tasks and record the outcomes of these assessments directly on the form. The evaluator's name is also recorded to ensure transparency and accountability in the evaluation process.

3. How is the performance of soldiers assessed using this form?

   Performance is assessed through a series of tasks outlined in advance, each with its own criteria for what constitutes a pass or fail. For each task, the soldier is either marked as 'GO' (pass) or 'NO GO' (fail) based on their ability to meet the established standards. This binary assessment method simplifies the evaluation process and provides clear, actionable feedback to the soldier.

4. Can this form be revised or updated?

   Yes, the DA Form 5164-R, like many military forms, is subject to revision and updates. These changes are typically made to reflect current training needs, changes in operational procedures, or improvements in assessment methodologies. It's important for personnel to use the most recent version of the form to ensure compliance with current standards and procedures. The bottom of the form indicates its version and the statement "EDITION OF DEC 82 IS OBSOLETE" suggests that previous versions should no longer be used once an update has been released.

5. Where can one find the most current version of the DA Form 5164-R?

   The most current version of the DA Form 5164-R can typically be found through the Army Publishing Directorate (APD) website or through internal military channels designated for distributing such forms. Soldiers and evaluators are encouraged to verify they have the most up-to-date form before proceeding with the evaluation process to ensure all standards and procedures are current.

6. What happens after the evaluation is completed?

   Upon completion of the evaluation, the form is processed according to the unit's procedures. This usually involves a review by the soldier's immediate supervisors to discuss the results and determine any necessary steps for improvement or further training. Completed forms become part of the soldier's personal record, where they can be used for performance reviews, promotion considerations, and professional development planning.

7. Is there a digital version of the DA Form 5164-R?

   As of the latest updates, a digital or electronic version of the DA Form 5164-R may be available, reflecting the military's ongoing efforts to modernize and streamline administration. When available, digital forms offer ease of distribution, filling, and storage. Users should check with their unit's administrative office or the Army Publishing Directorate for access to digital formats and instructions on their proper use.

When filling out the DA Form 5164-R, individuals often make a range of mistakes. These errors can impede the accurate assessment of performance and complicate administrative processes. Being mindful of common pitfalls can enhance the form’s effectiveness as a tool in hands-on evaluations.

1. Not verifying the form's edition: People sometimes overlook the necessity of using the latest edition of the form. The DA Form 5164-R was updated in September 1985, and using a preceding version, such as the December 1982 edition, might lead to submission issues.

2. Incorrect or incomplete evaluator details: The evaluator’s name section is frequently filled inaccurately or left blank. It's crucial for the evaluator to provide their full name to ensure accountability and clarity in the evaluation process.

3. Omission of the soldier’s name: Just like the evaluator’s details, the soldier’s name must be filled out completely and correctly. This information is essential for matching the form to the individual being evaluated.

4. Failing to mark the performance status appropriately: The form includes a section to indicate whether a task was performed successfully (GO) or unsuccessfully (NO GO). Commonly, evaluators forget to mark these sections or mark them incorrectly, leading to ambiguity in the soldier's performance records.

5. Inadequate detail in the performance step titles: The DA Form 5164-R requires specific titles for each performance step evaluated. A common mistake is to provide vague or incomplete titles, which can lead to confusion about what was assessed.

6. Misunderstanding the scoring system: The form requires a checkmark in either the PASS or FAIL boxes to score each performance step. However, individuals often misunderstand this scoring system, leading to errors such as putting numeric scores or leaving both unchecked.

Attention to detail and thoroughness in completing the DA Form 5164-R are essential for its effectiveness. Avoiding these common mistakes will improve the accuracy of the evaluation and the utility of the form in performance assessment processes.

Completing the DA Form 5164-R, which is crucial for hands-on evaluations in the military, often demands supplementary documentation to ensure a comprehensive assessment and record. These additional forms and documents play vital roles in the evaluation process, each serving a distinct but complementary purpose to the DA Form 5164-R. Here is an outline of some common forms and documents typically used alongside the DA Form 5164-R.

• DA Form 4856: This is the Developmental Counseling Form. It's used to document counseling sessions between leaders and their subordinates. In the context of a hands-on evaluation, it may record discussions about performance, goals, and how to address any deficiencies identified during the evaluation.
• DA Form 4187: Personnel Action Form. Soldiers requesting certain personnel actions, like reassignment, extra training, or reevaluation, use this form. After an evaluation, if a soldier needs a follow-up action based on their performance, this form would come into play.
• DA Form 705: Army Physical Fitness Test Scorecard. Although not directly related to skill evaluation, physical fitness impacts overall performance. This form tracks a soldier's physical fitness test scores and might be reviewed alongside hands-on performance evaluations.
• DA Form 5500 (Male) and DA Form 5501 (Female): Body Fat Content Worksheet. These forms are used to calculate and record a soldier’s body fat percentage. Like the DA Form 705, they provide a holistic view of a soldier's physical readiness.
• NCOER (Non-Commissioned Officer Evaluation Report) or OER (Officer Evaluation Report): These evaluation reports provide detailed performance and potential assessments for non-commissioned officers and commissioned officers, respectively. They might be used alongside the DA Form 5164-R to give a more complete performance picture over time.
• ATP 7-22.7: The Noncommissioned Officer Guide. Though not a form, this guide provides the framework and standards for NCO development and evaluations. It offers context and benchmarks that could inform the interpretation of DA Form 5164-R results.

Collectively, these forms and documents offer a well-rounded approach to evaluating and documenting a soldier's performance and readiness. They ensure that evaluations are not only about passing or failing a specific task but also about growth, development, and comprehensive readiness. By utilizing these forms in tandem with DA Form 5164-R, leaders can provide meaningful feedback and actionable insights to support their soldiers' careers effectively.

• The DA Form 4856, also known as the Developmental Counseling Form, holds similarities to the DA Form 5164-R due to its structured approach in assessing soldiers' performances, albeit in a counseling context. Both forms facilitate official record-keeping and promote structured feedback between evaluators and soldiers, with distinct sections for observations, scores, or outcomes.

• The DA Form 3349, or Physical Profile Form, is comparable to the 5164-R in that it evaluates the physical capabilities of soldiers against specific standards. Although it focuses on the physical and not task-specific performance, both documents serve to document individual performance, highlighting areas of strength and need for improvement.

• Similar to the DA Form 5164-R, the DA Form 638, Recommendation for Award, is used within the Army to record noteworthy performances. However, instead of evaluating routine tasks, the 638 is used for recognizing outstanding achievements. Both forms emphasize individual accomplishments and performance distinction.

• The DA Form 705, Army Physical Fitness Test Scorecard, is analogous to the 5164-R in its purpose to document the performance of soldiers, specifically regarding their physical fitness. Both forms use a scoring system to evaluate and record the performance of individuals in specific criteria.

• Lastly, the DA Form 5500 (Body Fat Content Worksheet) and DA Form 5164-R are similar in the sense that both require evaluators to record specific measurements and scores. Although the 5500 focuses on body composition and the 5164-R on task performance, both are essential for maintaining Army standards and ensuring soldier readiness.

When filling out the DA Form 5164-R, it's crucial to approach the task with attention to detail and adherence to guidelines. This form is used to document hands-on evaluations, an essential part of assessing and documenting the performance and proficiency of individuals. Here’s a list of dos and don’ts that will help ensure the process is done correctly and efficiently.

Things You Should Do:

1. Review instructions: Before starting, carefully read the relevant sections of STP 11-25S14-SM-TG, the guide that details the proper use of the form. Understanding the instructions ensures accuracy and compliance.
2. Use a black or blue ink pen: Fill out the form in black or blue ink to ensure that it is legible and that the information stands the test of time.
3. Double-check details: Verify the soldier's name, unit status, and task number for accuracy. Mistakes could lead to discrepancies in records or evaluations.
4. Clearly indicate performance: Mark the appropriate box for pass or fail clearly. This clarity is crucial for the accurate assessment of the individual's capabilities.
5. Sign and date the form: Ensure the evaluator's name is clearly printed, signed, and the form is dated. This adds authenticity and accountability to the evaluation.
6. Store securely: Once completed, the form should be stored in a secure location. This safeguards the privacy and integrity of the performance evaluation.

Things You Shouldn’t Do:

1. Use pencil or erasable ink: These can fade or be altered, which might result in data loss or tampering.
2. Skip sections: Every part of the form is important. Leaving blank spaces might lead to an incomplete evaluation, impacting the accuracy of the records.
3. Make assumptions: Only mark performance based on observable, measurable actions during the evaluation. Assumptions can lead to unfair or inaccurate assessments.
4. Rush through the process: Take your time to observe thoroughly and record accurately. Hasty evaluations can overlook crucial details.
5. Disclose information carelessly: As the form contains personal and performance information, sharing it without proper authorization violates privacy policies.
6. Alter information post-submission: Once the form is submitted, do not attempt to change any details without going through the proper channels to maintain integrity and transparency of the documentation process.

Misconceptions about the DA Form 5164-R, often utilized for hands-on evaluation within the military, can lead to confusion and inaccuracies in its application. Clarifying these misunderstandings ensures that evaluators and participants alike can navigate the process more effectively. Here are four common misconceptions:

• "The DA Form 5164-R is only used for negative assessments." This is a misconception because the form is designed to record both "GO" (pass) and "NO GO" (fail) outcomes. Its primary purpose is to document the performance of soldiers in a specific task, not just to highlight deficiencies.
• "Any Army personnel can conduct evaluations using the DA Form 5164-R." In reality, only qualified evaluators or those specifically designated by the proponent agency, usually TRADOC (Training and Doctrine Command), are authorized to use this form for evaluations. This ensures that assessments are standardized and valid.
• "Results on the DA Form 5164-R have no impact on a soldier's career." Contrary to this belief, the outcomes recorded on this form can significantly influence a soldier's career, particularly in areas related to promotions, special assignments, or additional training opportunities. It provides official documentation of a soldier's competence in specific tasks.
• "The DA Form 5164-R can be casually discarded after evaluation." This is incorrect as the form should be properly filed and maintained in the soldier's personnel file or training records. It serves as an official record of performance and can be reviewed for future training assessments, development discussions, or administrative purposes.

Understanding the purpose and significance of the DA Form 5164-R not only facilitates a smoother evaluation process but also highlights the importance of accurate and thorough record-keeping within the military's training and development programs.

Understanding the DA Form 5164-R is crucial for accurately documenting a soldier's performance during hands-on evaluations. Below are ten key takeaways to guide you in filling out and using this form effectively:

• Ensure you have the latest version of the form. The DA Form 5164-R was updated from its previous version of DEC 82, indicating revisions might occur. Always verify you are using the current edition specified as APD V2.01.
• Correctly identify the task being evaluated. Each form is task-specific, requiring the task title, date, and task number to be filled in accurately to ensure proper documentation and assessment.
• Performance steps are crucial. Each itemized performance step must be clearly marked with a score, indicating whether the soldier has passed (P) or failed (F) that particular step. This specificity is essential for both the soldier's feedback and future training needs.
• The form allows for both "GO" and "NO GO" assessments. It is important to understand the criteria for each and apply them consistently across evaluations to maintain fairness and integrity in the assessment process.
• Pay close attention to the evaluator's section. The evaluator must provide their name, showcasing who conducted the assessment. This ensures accountability and provides a contact point for any clarifications or disputes.
• Identifying the soldier accurately is imperative. Including the soldier's name prevents any confusion regarding who is being evaluated, especially in units with multiple ongoing assessments.
• The form's design caters to multiple evaluations. With checkboxes for "PASS" and "FAIL" and spaces for both "GO" and "NO GO" ratings, evaluators can conduct comprehensive assessments on a range of competencies.
• Documenting unit status helps in tracking progress and identifying areas that need improvement at the unit level. This collective data can inform training priorities and resource allocation.
• Completing the form properly is essential for the soldier's career progression. The DA Form 5164-R is an official document that can affect promotions, assignments, and specialized training opportunities based on performance.
• Lastly, ensure that the form is filed appropriately according to your unit's standard operating procedures. The documentation must be accessible for reviews, updates, and future references, contributing to the professional development of the evaluated soldier.

Filling out the DA Form 5164-R meticulously and thoughtfully carries significant implications for soldiers and their careers. By following these key takeaways, evaluators can provide accurate, fair, and developmental feedback that aligns with the army's standards and expectations.