DD Form 441 "Department of Defense Security Agreement"

What Is DD Form 441?

DD Form 441, Department of Defense Security Agreement, is an agreement signed between the United States Government and an independent contractor. The U.S. Department of Defense (DoD) released this form - sometimes incorrectly referred to as the DA Form 441 - on March 1, 2020. You can download the current DD Form 441 fillable version through the link below.

Alternate Name:

  • DoD Security Agreement.

DD Form 441-1, Appendage to Department of Defense Security Agreement, is an attachment to the DoD security agreement. It contains a list of divisions and branch offices covered by the main security agreement and Standard Form 328, Certificate Pertaining to Foreign Interests. If your company is a division or branch of a company that has already obtained a facility security clearance (FCL), your company will be included under the umbrella of the Security Agreement signed by the Home Office company. In this case, your clearance will be documented on DD Form 441-1.

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How to Use DD Form 441?

When a company needs to access the national security information required to enter into a contract or respond to a request, it has to obtain an FCL first. The FCL is granted if the federal government determines that providing your company with access to the information classified as "Confidential," "Secret," or "Top Secret" is in the interest of national security. You cannot apply for an FCL on your own account. It is required that the classified contract be granted to your company by a federal government agency or by any company that has already obtained its FCL.

DD Form 441 is executed at the time of the facility clearance approval and is considered a legally binding document between the United States Government and the contractor. By signing this document, you agree to establish a Security Program and comply with the security requirements described in the National Industrial Security Program Operating Manual (NISPOM). Execution of the form allows your organization to work on the classified contract. It also allows the federal government to review the Security Program you have established in order to ensure it complies with the rules and regulations.

How to Fill Out DD Form 441?

DD Form 441 instructions are as follows:

  1. Remember that the form is a legally binding agreement between your company and the United States Government. Make sure you have read the security responsibilities of both sides before filling out the form.
  2. Prepare two copies of DD Form 441. One of them will be kept by the Defense Security Service (DSS) and your organization maintains the other. Fill out all the required fields. Do not complete the date field on page 1, as well as the fields intended for completion by the Government Representative.
  3. The document can be signed by the company employee or representative authorized to enter into an agreement with the United States Government on behalf of the company. The document must also contain the signature of one witness. This witness must be an individual who observed the company representative or employee signing the contract. The Witness section must contain the witness' signature, date, and witness' name typed or printed under the signature.
  4. It is prohibited for the individual signing the contract as the government representative to sign as a witness too. The United States Government encourages you to submit the completed and signed form via the National Industrial Security System website instead of returning it to your respective cognizant security office.

After your company is sponsored for an FCL, the Industrial Security Representative will be assigned by the DSS to help you to follow the NISPOM requirements. Find more information regarding the procedure in the Code of Federal Regulation: Title 48 - Federal Acquisition Regulations System.

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Download DD Form 441 "Department of Defense Security Agreement"

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OMB No. 0704-0194
DEPARTMENT OF DEFENSE SECURITY AGREEMENT
OMB approval expires
20221031
PLEASE DO NOT RETURN YOUR FORM TO THE ORGANIZATION IN THE PARAGRAPH BELOW. RETURN COMPLETED FORM TO YOUR RESPECTIVE COGNIZANT
SECURITY OFFICE.
The public reporting burden for this collection of information is estimated to average 14 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.
This DEPARTMENT OF DEFENSE SECURITY AGREEMENT (hereinafter called the Agreement), entered into this
day of
,
by and between THE UNITED STATES OF AMERICA through the Defense Counterintelligence and
(hereinafter called the Contractor), which is:
(1) A
organized and existing under the laws of the state of
.
(Enter type of business entity, e.g., Corporation, Limited Liability Company, etc.)
(2) a partnership consisting of
(3) an individual trading as
WITNESSETH THAT:
DD FORM 441, MARCH 2020
PREVIOUS EDITION IS OBSOLETE.
OMB No. 0704-0194
DEPARTMENT OF DEFENSE SECURITY AGREEMENT
OMB approval expires
20221031
PLEASE DO NOT RETURN YOUR FORM TO THE ORGANIZATION IN THE PARAGRAPH BELOW. RETURN COMPLETED FORM TO YOUR RESPECTIVE COGNIZANT
SECURITY OFFICE.
The public reporting burden for this collection of information is estimated to average 14 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.
This DEPARTMENT OF DEFENSE SECURITY AGREEMENT (hereinafter called the Agreement), entered into this
day of
,
by and between THE UNITED STATES OF AMERICA through the Defense Counterintelligence and
(hereinafter called the Contractor), which is:
(1) A
organized and existing under the laws of the state of
.
(Enter type of business entity, e.g., Corporation, Limited Liability Company, etc.)
(2) a partnership consisting of
(3) an individual trading as
WITNESSETH THAT:
DD FORM 441, MARCH 2020
PREVIOUS EDITION IS OBSOLETE.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year written above:
THE UNITED STATES OF AMERICA
(Signature of Authorized Government Representative)
(Typed Name of Authorized Government Representative)
(Typed Name of Authorized Government Agency)
(Typed Name of Contractor Entering Agreement)
WITNESS
(Signature and Date)
(Signature of Authorized Contractor Representative)
(Typed Name of Authorized Contractor Representative)
NOTE: The witness must be a person who personally observed the
(Title of Authorized Contractor Representative)
Contractor Representative sign this form. The witness cannot be the
same person who signs this form as the Government Representative.
The name of the witness should be typed or printed under the witness'
signature and date.
(Contractor Address)
(Contractor Address)
By executing this form, the Contractor Representative certifies that he or she is the
of the business entity identified above, and has the authority to bind the business entity to the terms of this agreement.
DD FORM 441 (BACK), MARCH 2020
RESET
PREVIOUS EDITION IS OBSOLETE.
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