FLIGHT CLEARANCE

FOR
INDONESIAN TERRITORY
Republic of Indonesia Approval Number : MI0022

Penerbangan Pesawat Udara Negara/Militer Asing ini telah diizinkan oleh Pemerintah Republik Indonesia:
The following Foreign State/Military Aircraft Flight has been approved by the Government of the Republic of
Indonesia:

1. Pesawat Udara
Aircraft
a) Operator (Pemilik/Penyewa)
: US. GOV 203
Operator (Owner/Charterer)
b) Tipe
: C-17
Type
c) Tanda Pendaftaran/Negara
: United States of America
Registration/Country
d) Nama Panggilan
: RCH4535
Call Sign
e) Nomor Registrasi 10187 ALT: 10187, 66155, 66156, 66157, 66158, 66159, 66160, 66161,
:
Registration Number 66162, 66163, 66164, 77172, 77179
2. Penerbangan
Flight
a) Rute GUAM - WIII/SOEKARNO HATTA - GUAM; CAHYO A450 MKS T6 KURUS WIII;
:
Routes WIII CA T5 MKS A450 CAHYO
b) Tanggal masuk ke Indonesia a.1)
Penerbangan Langsung
Date entering Indonesia : 07/09/2023 : YES
Direct Flight
(UTC)
c) Tanggal keluar dari Indonesia a.2) YES,
Pendaratan Teknis di
Date leaving Indonesia : 07/09/2023 : WIII/SOEKARNO
Technical Landing at
(UTC) HATTA
d) Nama Pilot : a.3) Menginap
CAPT JON HOBBS : NO
Name of Pilot in Command Remain Overnight at
e) Awak pesawat udara lainnya *1)
: CAPT STEPHEN PARKER
Other crew member(s)
f) Penumpang/barang *2)
: AIRCREW, PAXS, AND CARGO
Passenger(s)/cargo
3. Keterangan
Remarks
: IN SUPPORT OF VIP VPOTUS ARRIVAL ASEAN SUMMIT REDEPLOY

MASA BERLAKU PADA TANGGAL KEDATANGAN DAN 72 JAM SESUDAHNYA

VALIDITY
: 72HRS AFTER DUE DATE (ENTRY DATE)

Note: Berlaku untuk 1 (satu) kali penerbangan PEMOHON

1) and 2) Name(s)/cargo should be written/attached Valid for one flight
Aircraft, crew, passengers and load are subject to the APPLICANT
terms of Chicago Convention and have to comply with the
Indonesian Regulations as for entry clearance,
immigration, customs, and quarantine. Possesion of this
flight clearance does not exempt an operator from US. EMBASSY
compliance with any of the technical operations ruler or
airworthiness requirements of the Directorate General of JAKARTA
Civil Aviation This flight clearance can be withdrawn
without previous notice. Should delay exceed the date as
prescribed in point 2b) and 2c) this fight will be regarded
as cancelled. (Signature and Name)

DISETUJUI OLEH
APPROVED BY
Kementerian Luar Negeri Direktorat Konsuler
Ministry of Foreign Affairs
Markas Besar TNI Sintel Mabes TNI
INDF - Headquarter