Atch-06 DD2401.pdf

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2401, MAY 2021

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 OMB approval expires

Aug 31, 2027

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, at whs.mc-alex.esd.mbx.dd-dod-informationcollections@mail.mil. 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 APPROPIATE ADDRESS ON BACK.

SECTION I - INFORMATION REQUIRED FROM USER

Permission is requested to use the listed military arifield(s). It is understood and agreed that:

a. Except for weather alternate use or emergencies, I or my agent will contact each installation commander at least 24 hours prior to each landing for final clearance instructions.

The remarks section of the flight plan will include user name and permit identification number.

b. When required, I or my agent will obtain diplomatic or overflight clearance when operating over international borders.

c. Commanders of military installations may restrict civil aircraft operations to preclude interference with military activities or to protect national security.

d. This permit does not necessarily entitle my aircraft to receive aviation fuel, oil, or other services from U.S.

Government sources.

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

1. USER

a. NAME

b. RELATIONSHIP TO PARENT ORGANIZATION (If any)

c. ADDRESS (Street, City, State, Zip Code, E-Mail) 2. NAMES OF AIRFIELD(S) TO BE USED

3. ARE PILOTS INSTRUMENT

RATED AND CURRENT? (X one)

YES

NO

4. PURPOSE OF USE

5. AIRCRAFT DATA

a.

MANUFACTURE

b.

MODEL

c.

REGISTRATION

NUMBER

d. CAPACITY

(2)

PASSEN-

GER

(1)

CREW

e. MAX

GROSS

TAKE-OFF

WEIGHT

(Pounds)

f. EQUIPMENT

(1) TWO-WAY

RADIO

YES NO

(2) STROBE

WARNING

LIGHTS

YES NO

(3) TRANS-

PONDER

YES NO

(4) IFR CAPA-

BILITIES

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) b. TITLE c. TELEPHONE NUMBER (Include Area Code)

d. SIGNATURE e. DATE SIGNED

(YYYYMMDD)

(Updated 20251215)

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2401, MAY 2021

SECTION II - FOR USE BY APRROVING AUTHORITY

7. PERIOD OF USE

a. FROM

(YYYYMMDD)

b. TO

(YYYYMMDD)

8. FREQUENCY OF USE 9. IDENTIFICATION NO. 10. THIS PERMIT SUPERSEDES

PERMIT NO. (Identification No.)

11. THIS PERMIT IS GRANTED ON PRIOR EXECUTION OF DD FORMS 2400 AND 2402

a. DD FORM 2400 (Dated and Filed) b. DD FORM 2402 (Dated and Filed)

12. CREDIT AUTHORIZED

FOR FUEL ISSUES (X one)

YES NO

13. LANDING

FEES (X one)

YES 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 at http://www.esd.whs.mil/Directives/forms/dd2000_2499/

ARMY

COMMANDER, USAASA, ATTN: DAMO-AVA

BLDG 1466, 9325 GUNSTON RD, SUITE N319

FT BELVOIR, VA 22060-5582

(703) 851-1290 usarmy.belvoir.list.army-calp-g-3-5-7@army.mil

AR 95-2 Can be viewed at: https://armypubs.army.mil/

AIR FORCE

HQ USAF/A3OJ

1480 Air Force, Rm. 4D755 Pentagon AFB, DC 20330

(703) 693-9444 calp@us.af.mil

AFI 10-1001 can be viewed at: https://www.e-publishing.af.mil/

NAVY

COMMANDER, NAVY INSTALLATIONS COMMAND

WASHINGTON NAVY YARD

716 SICARD ST SE

WASHINGTON, DC 20374

(202) 433-0120 calphq@us.navy.mil CNIC Program Guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html

MARINES

COMMANDER, MARINE CORPS INSTALLATIONS COMMAND

3000 MARINE, CORPS PENTAGON RM 2D153A

WASHINGTON, DC 20350-3000

(703) 695-0105 mcicom_calp@usmc.mil

MCICOM guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html

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, indicates that an individual or corporation has met the conditions required to request a PPR to land civil aircraft at a military facility.

ROUTINE USE(S): None. For Internal Use Only.

DISCLOSURES: Voluntary; however, failure to provide this information will result in an individual or corporation being unable to operate civil aircraft info a military airfield.