DD Form 2401 Civila Aircraft Landing Permit

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

OMB No. 0701-0050

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, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 1155
Defense Pentagon, Washington, DC 20301-1155 (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 may
emergencies, I or my agent will contact each
restrict civil aircraft operations to preclude
installation commander at least 24 hours prior to interference with military activities or to
each landing for final clearance instructions.
protect national security.
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.

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.
g. An approved copy of this permit must be aboard
each aircraft using the military airfield.
2. NAME OF AIRFIELD(S) TO BE USED

1. USER
a. NAME

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

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
d. CAPACITY
a. MANUFACTURE

b.
MODEL

c. REGISTRATION
NUMBER

(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
Initial)

DD FORM 2401, JAN 2008

b. TITLE

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

32 CFR 766
Can be viewed at: http://calp.navfac.navy.mil

NOTE 2
COMMANDER
USAASA, ATTN: ATAS-AS
BLDG 1466
9325 GUNSTON RD, SUITE N319
FT BELVOIR, VA 22060-5582
(703) 806-0686

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/A30-AC
1480 AIR FORCE PENTAGON RM 5E857
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), JAN 2008

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