Mutual of Omaha policy-machine insurance application cards, Portland 11/24/71
Title revised to match the document’s own text.
Original title: Mutual of Omaha policy-machine insurance application cards, PDX 11/24/71
Document date 24 November 1971
Report a problem
Email this to [email protected]
Id: Cooper-Part-18:137-138
Subject: Cooper Files: Cooper-Part-18:137-138 Document: Mutual of Omaha policy-machine insurance application cards, Portland 11/24/71 Id: Cooper-Part-18:137-138 Page: https://cooper.theunsolved.net/documents/Cooper-Part-18%3A137-138 What is wrong (title, date, type, which pages belong together, copies)? What does the scan show?
A person reads every report. Corrections are made by hand, to the data — titles, dates, names, which pages belong together — never to the scans, and they can take a while to appear.
FBI 164-81, Vault Part 18 pp. 137–138 (DB Cooper-5470–5471), Form, dated 24 Nov 1971 — cooper.theunsolved.net/documents/Cooper-Part-18%3A137-138
[redacted name block - b6/b7C]
Boise Sears Portland Boise
Nov 24 71
[illegible faint text at bottom of section]
---
[redacted block - b6/b7C]
PORTLAND PORTLAND SAN FRANCISCO
11/24/71
---
IMPORTANT THIS CARD IS TO BE DEPOSITED IN SLOT DESIGNATED ON POLICY MACHINE
Application to Mutual of Omaha Insurance Company Insured Name [redacted - b6/b7C] Benef. Name [redacted - b6/b7C] Street ........................ City.. PORTLAND ............ State. ORE. Point of Departure PORTLAND .................. Desti- nation mpls.. Minn. ......... Trip to Be ☐ One-way ☑ Round Made on: Ticket trip Ticket Date and Time of Purchase ... 11.. 24.. 71 ........ Insured is owner ☐ Beneficiary unless checked here: is owner. Signature of Insured ..[redacted]............... 844M App
---
T33AV-M2 DB Cooper-5470
MUTU DUPLICATE APPLICATION Premium Paid WRITE Resident Agent Point of Departure .. Portland .......... [illegible] Trip to be made on: Destination: Jamestown N. Dakota ☐ One-way Ticket Time ☐ Round-
Insured's Name .. Beneficiary's Name ..
Street -
City: ..1..1..9. [guess: PRO].... State ..ORE...... Insured is owner unless checked here: ☐ Beneficiary is owner.
Insured's *Signature ................................ 842M App -M - Series 30165
► APPLICATION RETAINED BY MACHINE ◄
The Principal Sum of this policy is that amount which the premium stamped on the above application will purchase in accordance with the Rate Schedule on the reverse side. The policy requires advance ticketing for designated round trip (except shuttle or in-flight ticketing) before leaving Point of Departure as specified in Part A. The Maximum Principal Sum for which this policy may be issued is $75,000. In the event that the premium stamped on the application is greater than the applicable premium specified in the Rate Schedule for said maxi- mum Principal Sum, the excess premium will be re- turned upon demand. This insurance is binding only if the application has been completed and personally signed by the Insured and has been stamped by the Tele-Trip validator machine.
SCHEDULED AIRLINE TRIP INSURANCE POLICY
---
[IMPORTANT] THIS CARD IS TO BE ENCLOSED IN SLOT DEPOSIT 25¢ ON POLICY MACHINE
[Form fields, partially legible:] [illegible] .......... State ......... Departure ................. [illegible] 1½ to 62 ☐ One-way ☐ Round [guess: Made] on: Ticket trip Ticket Date and Time of Purchase .. Insured is owner ☐ Beneficiary unless checked here: is owner. Signature of Insured .. [illegible] 844M App
T33AV-M2 [handwritten:] 2mrs [or similar]
[Below, inverted/mirrored text visible:] [guess: 11/61 '72 -1201[illegible]] [handwritten entries, partially illegible] [guess: ticket] ☐ [guess: Bond] ☐ [guess: Money] [illegible] [illegible handwritten amounts and signatures]
---
DESIGNATED NO POLICY MACHINE DEPOSITED IN SLOT THIS CARD IS TO BE
IMPORTANT
---
DB Cooper-5471
Serials: 844M App, Series 30165, T33AV-M2