DD Form 2249 DoD Building Pass Application - Draft

What Is DD Form 2249?

DD Form 2249, DoD Building Pass Application is a form used to investigate the individuals applying for access to Department of Defense (DoD) buildings for official duties. Form DD 2339 must be submitted by the requesting DoD Component to the Building Pass Branch, PSD, at Washington Headquarters Services (WHS).

The latest edition of the form - sometimes confused with the DA Form 2249, Chaplain's Fund Statement of Operations and Net Worth - is currently stocked and issued by the WHS and the Pentagon Force Protection Agency (PFPA). A draft of the DD Form 2249 fillable version can be downloaded below or found on the General Services Administration (GSA) Regulatory Information Service Center website.

If the military pass is lost, stolen or damaged, the employee should visit the Building Pass Office to replace it ASAP. Applicants must provide any identifying document to initiate the process. A driver's license or an old pass - if the applicant still has it - will do.

A related form - the DD Form 1469, Temporary DoD Building Pass - grants an individual access to a specific building for a period of 120 days. It can also be temporarily issued to a new employee awaiting the completion of an Entrance National Agency Check (ENTNAC), National Agency Check (NAC), National Agency Check and Inquiries (NACI), or Background Investigation.

ADVERTISEMENT
OMB No. 0704-0328
DOD BUILDING PASS APPLICATION
OMB approval expires
(PERMANENT)
The public reporting burden for this collection of information is estimated to average 6 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 (0704-0328). 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. RETURN COMPLETED FORM TO THE BUILDING PASS OFFICE
TO WHICH YOU ARE APPLYING.
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301; EO 12356; EO 9397.
PRINCIPAL PURPOSES: To facilitate verification of background investigations for individuals applying for access to DoD buildings in connection
D R A F T
with their official duties.
ROUTINE USES: Information may be furnished to Federal, state, or local agencies for regulatory and law enforcement purposes.
DISCLOSURE: Voluntary; however, refusal to furnish requested information may result in inability to verify essential personal information and
approve requested building pass application.
2a. SOCIAL SECURITY
b. DATE OF BIRTH
1. NAME OF APPLICANT
NUMBER
(YYYYMMDD)
a. LAST
b. FIRST
c. MIDDLE
INITIAL
3. BACKGROUND INVESTIGATION DATA
YEAR
MONTH
YEAR
MONTH
(1)
(2)
(1)
(2)
b. NATIONAL AGENCY CHECK OR
a. BACKGROUND INVESTIGATION
SPECIAL AGENCY CHECK
COMPLETED
COMPLETED
4. EMPLOYMENT CATEGORY (X one)
a. GOVERNMENT
c. CONTRACTOR
(1) ESCORT
e. DOES THE APPLICANT NEED TO
ESCORT OTHERS TO PERFORM
N E E D S D D 6 7
HIS OR HER DUTIES? (X one)
b. FOREIGN
d. PRESS
(2) NO ESCORT
5. BUILDING ACCESS REQUESTED (X one)
a. PENTAGON
c. OTHER (Specify)
(1) 24 HOUR ACCESS
d. ACCESS HOURS
(X one)
b. NCR
(2) BUSINESS HOURS ONLY
(Complete Item 6)
6. JUSTIFICATION FOR NCR ACCESS (List buildings which require 24/7 access.)
7. PASS INFORMATION
a. EXPIRATION DATE OF
b. REASON FOR ISSUANCE (X one)
NEW PASS (YYYYMMDD)
(1) INITIAL ISSUE
(2) RENEWAL
(3) NAME CHANGE
8. AUTHORIZED/REQUESTING OFFICIAL
a. NAME (Last, First, Middle Initial)
b. TELEPHONE NUMBER (Include area code)
c. SIGNATURE
d. DATE SIGNED (YYYYMMDD)
DD FORM 2249, 20100203 DRAFT
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 8.0
OMB No. 0704-0328
DOD BUILDING PASS APPLICATION
OMB approval expires
(PERMANENT)
The public reporting burden for this collection of information is estimated to average 6 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 (0704-0328). 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. RETURN COMPLETED FORM TO THE BUILDING PASS OFFICE
TO WHICH YOU ARE APPLYING.
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301; EO 12356; EO 9397.
PRINCIPAL PURPOSES: To facilitate verification of background investigations for individuals applying for access to DoD buildings in connection
D R A F T
with their official duties.
ROUTINE USES: Information may be furnished to Federal, state, or local agencies for regulatory and law enforcement purposes.
DISCLOSURE: Voluntary; however, refusal to furnish requested information may result in inability to verify essential personal information and
approve requested building pass application.
2a. SOCIAL SECURITY
b. DATE OF BIRTH
1. NAME OF APPLICANT
NUMBER
(YYYYMMDD)
a. LAST
b. FIRST
c. MIDDLE
INITIAL
3. BACKGROUND INVESTIGATION DATA
YEAR
MONTH
YEAR
MONTH
(1)
(2)
(1)
(2)
b. NATIONAL AGENCY CHECK OR
a. BACKGROUND INVESTIGATION
SPECIAL AGENCY CHECK
COMPLETED
COMPLETED
4. EMPLOYMENT CATEGORY (X one)
a. GOVERNMENT
c. CONTRACTOR
(1) ESCORT
e. DOES THE APPLICANT NEED TO
ESCORT OTHERS TO PERFORM
N E E D S D D 6 7
HIS OR HER DUTIES? (X one)
b. FOREIGN
d. PRESS
(2) NO ESCORT
5. BUILDING ACCESS REQUESTED (X one)
a. PENTAGON
c. OTHER (Specify)
(1) 24 HOUR ACCESS
d. ACCESS HOURS
(X one)
b. NCR
(2) BUSINESS HOURS ONLY
(Complete Item 6)
6. JUSTIFICATION FOR NCR ACCESS (List buildings which require 24/7 access.)
7. PASS INFORMATION
a. EXPIRATION DATE OF
b. REASON FOR ISSUANCE (X one)
NEW PASS (YYYYMMDD)
(1) INITIAL ISSUE
(2) RENEWAL
(3) NAME CHANGE
8. AUTHORIZED/REQUESTING OFFICIAL
a. NAME (Last, First, Middle Initial)
b. TELEPHONE NUMBER (Include area code)
c. SIGNATURE
d. DATE SIGNED (YYYYMMDD)
DD FORM 2249, 20100203 DRAFT
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 8.0
DOD BUILDING PASS APPLICATION
(TEMPORARY/NCIC REQUEST)
9. NAME OF APPLICANT
a. LAST
b. FIRST
c. MIDDLE INITIAL
10. SOCIAL SECURITY NUMBER
11a. DATE OF BIRTH (YYYYMMDD)
b. COUNTRY
12. PHYSICAL DESCRIPTION (This data is requested for identification purposes only, and is not a factor in determining eligibility.)
a. RACE (Mark one or more)
(1) AMERICAN INDIAN OR ALASKA NATIVE
(4) HISPANIC OR LATINO
(7) OTHER
(5) NATIVE HAWAIIAN OR
D R A F T
(2) ASIAN
OTHER PACIFIC ISLANDER
(3) BLACK OR AFRICAN AMERICAN
(6) WHITE
c. HEIGHT (Inches)
d. WEIGHT (Pounds)
b. SEX (X one)
(1) MALE
(2) FEMALE
c. IF "NO," INDICATE IMMIGRATION NUMBER AND
d. EXPIRATION DATE
13. IS APPLICANT A U.S. CITIZEN? (X one)
COUNTRY
(YYYYMMDD)
a. YES
b. NO
14. BACKGROUND INVESTIGATION DATA
YEAR
MONTH
INITIALS
(1)
(2)
(3)
a. BACKGROUND INVESTIGATION
(BI) INITIATED
b. NATIONAL AGENCY CHECK (NAC)/
SPECIAL AGENCY CHECK (SAC) INITIATED
c. BI COMPLETED
d. NAC/SAC COMPLETED
e. NCIC COMPLETED
15. EMPLOYMENT CATEGORY (X one)
a. GOVERNMENT
c. CONTRACTOR
(1) 24 HOUR
e. ACCESS HOURS
(X one)
b. PRESS
d. PENTAGON RENOVATION
(2) BUSINESS HOURS ONLY
16. BUILDING ACCESS REQUESTED (X one)
c. DOES THE APPLICANT NEED
a. PENTAGON
(1) ESCORT
TO ESCORT OTHERS TO
PERFORM HIS OR HER
b. OTHER (Specify)
(2) NO ESCORT
DUTIES? (X one)
17. PASS INFORMATION
a. EXPIRATION DATE OF NEW PASS
b. REASON FOR ISSUANCE (X one)
(YYYYMMDD)
(1) INITIAL ISSUE
(2) RENEWAL
(3) NAME CHANGE
18. AUTHORIZED/REQUESTING OFFICIAL
a. NAME (Last, First, Middle Initial)
b. TELEPHONE NUMBER (Include area code)
c. SIGNATURE
d. DATE SIGNED (YYYYMMDD)
DD FORM 2249 (BACK), 20100203 DRAFT
Reset

Download DD Form 2249 DoD Building Pass Application - Draft

1434 times
Rate
4.3(4.3 / 5) 72 votes
ADVERTISEMENT

How to Fill out DD Form 2249?

DD Form 2249 instructions are as follows:

  1. Boxes 1 requires the full name of the applicant. Their social security number is provided in Box 2a. Box 2b is for providing the date of birth.
  2. Box 3 verifies the background investigation. Box 3a is for the dates when the investigation was completed. Box 3b is for the dates when the NAC or Special Agency Check was completed.
  3. The applicant must specify their employment category and whether or not they will need to escort others into the building in Box 4.
  4. Box 5 requires the applicant to indicate which particular building they request access to and clarify the required access hours. If the applicant requires access to the NCR, the applicant should justify their request in Box 6.
  5. Box 7 is for the information on the expiration date of the new pass and the reason for pass issuance.
  6. Box 8 requires the full name of the authorizing official, their phone number, signature, and the date of signing the form. The signature of the official should certify that the applicant has received a proper security briefing.
Page of 2