FormMutual of Omaha scheduled airline trip insurance applications, Portland departurespage 12 of 18
formLegibility: medium

Part 18, page 130

DB Cooper-5463

Open in FBI Vault (Part 18, page 130 of the PDF)

FBI 164-81, Vault Part 18 p. 130 (DB Cooper-5463), Form, serial SE 164-81-1705 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-18/pages/130

Transcript

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

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

FIRMLY - You are making several copies

[Handwritten:] PORTLAND ORE Trip to be [Handwritten:] SAN JOSE made on: ☒ One-way Ticket ☐ Round- trip

[Handwritten:] LOS. A.L.T.O.S. ..... State CA.L. red is owner ☐ Beneficiary is owner red's Signature _______________ V-M (T33AY-M - Series 30189)

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

FIRMLY - You are making several copies

[Handwritten:] Portland, Oregon Trip to be [Handwritten:] Nashville, Le. Tenn.... made on: ☐ One-way Ticket ☒ Round- trip

[Handwritten:] MANNING ......... State ORE.. red is owner [illegible] checked [guess: here] or [illegible] red's Signatu _______________ (T33AY-M - Series 30189)

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

FIRMLY - You are making several copies

[Handwritten:] PORTLAND, ORE. Trip to be [Handwritten:] DENVER, COLO. made on: ☐ One-way Ticket ☒ Round- trip

[Handwritten:] SALEM. ......... State OR.[guess: egon] red is owner checked [illegible] red's Signatu _______________ V-M

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

FIRMLY - You are making several copies

[Handwritten:] PORTLAND, ORE. Trip to be [Handwritten:] TOLEDO - OHIO. made on: ☐ One-way Ticket ☒ Round- trip

[Handwritten:] TOLEDO. ........... State OHIO[guess: .] ired is owner nless checked [illegible] ired's Signatu _______________ AY-M

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DB Cooper-5463