DD Form 2401 Civila Aircraft Landing Permit

CIVIL AIRCRAFT LANDING PERMIT

OMB No. 0701-0050
OMB approval expires
Apr 30, 2007

Read Privacy Act Statement on back before completing this form.
If additional space is required, continue on back identifying by item number.

The public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0701-0050). Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. SEND COMPLETED FORM TO THE ADDRESS IN NOTE 2 ON BACK.
SECTION I - INFORMATION REQUIRED FROM USER
Permission is requested to use the listed military airfield(s). It is understood and agreed that:
a. Except for weather alternate use or
c. Commanders of military installations
emergencies, I or my agent will contact each
may restrict civil aircraft operations to
installation commander at least 24 hours prior
preclude interference with military
to each landing for final clearance instrucactivities or to protect national security.
tions. The remarks section of the flight plan
will include user name and permit
identification number.
d. This permit does not necessarily entitle
my aircraft to receive aviation fuel, oil, or
b. When required, I or my agent will obtain
other services from U.S. Government
diplomatic or overflight clearance when
sources.
operating over international borders.

g. An approved copy of this permit must be
aboard each aircraft using the military airfield.

1. USER

2. NAME OF AIRFIELD(S) TO BE USED

e. On-board personnel are not authorized
activities except for purposes directly connected
with this permit.
f. Use is limited to the listed aircraft, period
indicated, purpose stated, and conditions shown,
and is not transferable.

c. ADDRESS (Street, City, State, Zip Code)

a. NAME

b. RELATIONSHIP TO PARENT ORGANIZATION
(If any)

YES

3. ARE PILOTS INSTRUMENT
RATED AND CURRENT? (X one)

NO

4. PURPOSE OF USE

5. AIRCRAFT DATA

a. MANUFACTURE

b.
MODEL

c. REGISTRATION
NUMBER

d. CAPACITY
(1)
CREW

(2)
PASSENGER

e. MAX
GROSS
TAKE-OFF
WEIGHT
(Pounds)

f. EQUIPMENT
(1) TWO-WAY (2) STROBE (3) TRANS- (4) IFR CAPAWARNING
RADIO
PONDER
BILITIES
LIGHTS
YES

NO

YES

NO

YES

NO

YES

NO

6. CERTIFICATION BY INDIVIDUAL OR AUTHORIZED COMPANY REPRESENTATIVE

Applicant and agents have read, understand, and will comply with all pertinent parts of applicable regulations listed in
Note 1 and local supplements, directives, and orders. Such compliance is an express condition of this permit. I certify that
the information contained in this permit is true to the best of my knowledge and belief. As a corporate representative, I
certify that I have authority to certify this information on behalf of the corporation and hereby designate the aircraft
commander as our agent on all matters arising from the use of this permit.
a. TYPED NAME (Last, First, Middle b. TITLE
Initial)

DD FORM 2401, AUG 2004

c. TELEPHONE NO.
(Include Area Code)

d. SIGNATURE (Blue Ink)

PREVIOUS EDITION IS OBSOLETE.

e. DATE SIGNED
(YYYYMMDD)

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SECTION II - FOR USE BY APPROVING AUTHORITY
8. FREQUENCY OF USE
7. PERIOD OF USE
a. FROM (YYYYMMDD)

9. IDENTIFICATION NO.

b. TO (YYYYMMDD)

11. THIS PERMIT IS GRANTED ON PRIOR EXECUTION OF DD FORMS 2400 AND 2402
a. DD FORM 2400 (Dated and Filed)

10. THIS PERMIT SUPERSEDES
PERMIT NO. (Identification No.)

12. CREDIT AUTHORIZED
FOR FUEL ISSUES (X one)

b. DD FORM 2402 (Dated and Filed)

13. LANDING
FEES (X one)

YES

YES

NO

NO

14. APPROVING OFFICIAL
a. TYPED OR STAMPED NAME, TITLE AND ORGANIZATION

b. SIGNATURE

c. DATE SIGNED (YYYYMMDD)

IF ADDITIONAL SPACE IS REQUIRED, CONTINUE HERE (Refer to item number)

This form is available under DefenseLINK, Publications.
ARMY

NAVY

NOTE 1
AR 95-2
Can be viewed at: http://books.army.mil/
cgi-bin/bookmgr/Shelves

SECNAVINST 3770.1C
Can be viewed at: http://neds.nebt.daps.mil/
Directives/dirindex.html

NOTE 2
DIRECTOR
USAASA, ATTN: ATAS-AS
BLDG 1466
9325 GUNSTON RD, SUITE N319
FT BELVOIR, VA 22060-5582
(703) 806-4864

COMMANDER
NAVAL FACILITIES
ENGINEERING COMMAND
CODE: REAT
WASHINGTON NAVY YARD
1322 PATTERSON AVE. S.E., SUITE 1000
WASHINGTON, DC 20374-5065
(202)685-9202

AIR FORCE
AFI 10-1001
Can be viewed at: http://afpubs.hq.af.mil

HQ USAF/XOO-CA
1480 AIR FORCE PENTAGON RM 4D1010
WASHINGTON, DC 20330-1480
(703) 697-5967

PRIVACY ACT STATEMENT
AUTHORITY: 49 U.S. Code, Section 44502(d).
PRINCIPAL PURPOSE(S): When partially completed, indicates desire of an individual or corporation to operate civil aircraft
into a military airfield; when validated by a military approving authority, grants an individual or corporation permission to land
civil aircraft at a military airfield.
ROUTINE USE(S): None.
DISCLOSURE: Voluntary; however, failure to provide this information will result in an individual or corporation being unable
to operate civil aircraft into a military airfield.

DD FORM 2401 (BACK), AUG 2004

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