Dd Form 2402 - Civil Aircraft Hold Harmless Agreement Page 2
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1
2PRIVACY ACT STATEMENT
AUTHORITY: 49 U.S. Code, Section 44502(d).
PRINCIPAL PURPOSE(S): Indicates certification by an individual or corporation to hold the U.S. Government harmless in
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.
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 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.
5. This form is available under DefenseLINK, Publications.
ARMY
NAVY
AIR FORCE
NOTE 2
COMMANDER
DIRECTOR
NAVAL FACILITIES
ENGINEERING COMMAND
USAASA, ATTN: ATAS-AS
HQ USAF/XOO-CA
CODE: REAT
BLDG 1466
1480 AIR FORCE PENTAGON RM 4D1010
WASHINGTON NAVY YARD
9325 GUNSTON RD, SUITE N319
WASHINGTON, DC 20330-1480
1322 PATTERSON AVE. S.E., SUITE 1000
FT BELVOIR, VA 22060-5582
(703) 697-5967
WASHINGTON, DC 20374-5065
(703) 806-4864
(202)685-9202
DD FORM 2402 (BACK), AUG 2004
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