FormMutual of Omaha scheduled airline trip insurance applications, Portland departurespage 5 of 18
formLegibility: medium

Part 18, page 123

DB Cooper-5456

Open in FBI Vault (Part 18, page 123 of the PDF)

FBI 164-81, Vault Part 18 p. 123 (DB Cooper-5456), Form, serial SE 164-81-1705 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-18/pages/123

Transcript

The scan is the source; the transcript is machine-generated from it.

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Application to AL OF OMAHA INSURANCE COMPANY for scheduled airline trip insurance

FIRMLY - You are making several copies

[Depa]rture: PORTLAND [Desti]nation: MPLS. MINN.

Trip to be made on: □ One-way Ticket ☒ Round- trip

[Insur]ed is [redacted] WOODBURN.... State ORE.. [Un]less checked here: □ Beneficiary is owner. [Insur]ed's Signature ...............................

(T33AV-M - Series 30183)

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Application to AL OF OMAHA INSURANCE COMPANY for scheduled airline trip insurance

FIRMLY - You are making several copies

[Depa]rture: PORTLAND. [Desti]nation: MPLS. MINN.

Trip to be made on: □ One-way Ticket ☒ Round- trip

[b6] [b7C]

[Insur]ed is WOODBURN. State ORE.. [Un]less checked h[ere] [Insur]ed's Signatu[re]

(T33AV-M - Series 30183)

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Application to AL OF OMAHA INSURANCE COMPANY for scheduled airline trip insurance

FIRMLY - You are making several copies

[Depa]rture: Portland [Desti]nation: [guess: Indianapolis]. Ind.

Trip to be made on: □ One-way Ticket ☒ Round- trip

[Insur]ed is [redacted] [Un]less checked [here]: □ Beneficiary is owner.

... The Dalles.... State [guess: Ore]... [Insur]ed is owner [Insur]ed's Sign[ature]

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Application to AL OF OMAHA INSURANCE COMPANY for scheduled airline trip insurance

FIRMLY - You are making several copies

[Depa]rture: Portland, Oreg. [Desti]nation: [guess: Okla. City]

Trip to be made on: □ One-way Ticket □ Round- trip

[b6] [b7C]

[Insur]ed is [illegible] State [illegible] [Un]less checked he[re] [Insur]ed's Signature

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DB Cooper-5456