Dd Form 2402 - Civil Aircraft Hold Harmless Agreement (Page 2 of 2) in pdf

Dd Form 2402 - Civil Aircraft Hold Harmless Agreement Page 2

PRIVACY ACT STATEMENT

AUTHORITY:

49 U.S. Code, 1507

PRINCIPAL

Indicates certification by an individual or corporation to hold the U.S. Government harmless in

PURPOSE:

consideration of permission granted for the operation of civil aircraft into military aviation facilities.

Used in conjunction with DD Forms 2400 and 2401. It is maintained indefinitely.

None.

ROUTINE USE:

Voluntary; however, failure to provide this information will result in an individual or corporation

DISCLOSURE:

being unable to operate civil aircraft into a military aviation facility.

5. REMARKS (If additional space is required, continue here. Refer to item number.)

INSTRUCTIONS

1. Form must be filed along with DD Forms 2400 and 2401 to obtain a civil aircraft landing permit.

2. Complete all applicable items and submit to appropriate addresses in Note 2 below.

3. If the user is a corporation/company, all blocks must be completed and the form must be signed by two

different corporate officers. If the user is an individual, only Items 2b and 4 should be completed.

4. Original, handscribed signatures are required. Signature stamps, camera copied signatures, or any type of

facsimile signatures are unacceptable.

ARMY

NAVY

AIR FORCE

NOTE 2

COMMANDER

HQ USAF/XOOBC

DIRECTOR

NAVAL FACILITIES ENGINEERING

1480 AIR FORCE PENTAGON RM 5C966

USAASA, ATTN: MOAS-AS

COMMAND

WASHINGTON, DC 20330-1480

BLDG 1466

CODE 141JB

(703) 697-5967

9325 GUNSTON RD, SUITE N319

200 STOVALL STREET, ROOM 10N45

FT BELVOIR, VA 22060-5582

ALEXANDRIA, VA 22332-2300

(703) 806-4864

(703) 325-0475

DD FORM 2402, MAY 94 (BACK)

Dd Form 2402 - Civil Aircraft Hold Harmless Agreement Page 2