Part 18, page 102
FBI 164-81, Vault Part 18 p. 102 (DB Cooper-5435), Form — cooper.theunsolved.net/parts/Cooper-Part-18/pages/102
Transcript
The scan is the source; the transcript is machine-generated from it.
Policy Number A 059961[illegible trailing digit]
PERSONAL ACCIDENT WITH DOUBLE PROTECTION ON SCHEDULED AIRLINES Amount of Insurance: $20,000 Capital Sum (Scheduled Air) $10,000 Principal Sum (Other Acc.) PREMIUM $2.50
BAGGAGE AND PERSONAL EFFECTS $ [illegible] Amount of Insurance PREMIUM $[illegible]
COMBINED PREMIUM $[illegible] Term of Coverage: 14 Days
Name [redacted] Address of Insured [redacted] City [illegible] State [illegible] ZIP Code [illegible] Name of Beneficiary [redacted] Address of Beneficiary [redacted] City [illegible] State W[illegible] Code [illegible]
Effective at: Hour 9:00 p.m. Date 11 23 71 Month Day Year Place PDX
Personal Signature of Insured [redacted] AGENT COPY
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Policy Number A 059963
PERSONAL ACCIDENT WITH DOUBLE PROTECTION ON SCHEDULED AIRLINES Amount of Insurance: $[guess: 60],000 Capital Sum (Scheduled Air) $[guess: 20],000 Principal Sum (Other Acc.) PREMIUM $ [guess: 5.25]
BAGGAGE AND PERSONAL EFFECTS $ N AM[illegible] Amount of Insurance PREMIUM $ N [illegible]
COMBINED PREMIUM $[illegible] Term of Coverage: 3 Days
Name [redacted] Address of Insured [redacted] City [illegible] [guess: 2nd] State O[illegible] ZIP Code [illegible] Name of Beneficiary [redacted] Address of Beneficiary [guess: Sandra] [illegible] City [illegible] State [illegible] ZIP Code [illegible]
Effective at: Hour 7:45 p.m. Date 11 23 71 Month Day Year Place PDX
Personal Signature of Insured [redacted] AGENT COPY
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b6 b7C
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DB Cooper-5435