FormMutual of Omaha scheduled airline trip insurance applications, Portland departurespage 7 of 18
formLegibility: medium

Part 18, page 125

DB Cooper-5458

Open in FBI Vault (Part 18, page 125 of the PDF)

FBI 164-81, Vault Part 18 p. 125 (DB Cooper-5458), Form, serial SE 164-81-1705 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-18/pages/125

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

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

[Departure]: Portland, Oregon [Destination]: Reno, Nevada

[Beneficiary section mostly cut off]

City: Portland State: [illegible]

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

FIRMLY - You are making several copies

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

[Departure]: Portland, Oregon [Destination]: Rene [Reno], Nevada

[City]: Portland State: Ore.g[on] [checked]: ☒ Beneficiary is owner

ed's Signature: [blank]

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

FIRMLY - You are making several copies

[Name]: [guess: Sortland] [Destination]: [guess: Oakland] [illegible] Trip to be made on: ☐ One-way Ticket ☒ Round-trip

[City]: [guess: Bellevue] State: [illegible]

red is owner less checked red's Signature: [blank]

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

FIRMLY - You are making several copies

[Name/Departure]: [redacted - b6] Trip to be made on: [redacted - b7C] ☒ One-way Ticket ☐ Round-trip

[Destination]: [guess: AN/CI/to RAGE/H.L.] [illegible]

[City]: [guess: Albany] State: [guess: Oregon]

red is owner less checked here ☐ [Beneficiary] red's Signature: [blank]

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DB Cooper-5458