FormMutual of Omaha scheduled airline trip insurance applications, Portland departurespage 16 of 18
formLegibility: medium

Part 18, page 134

DB Cooper-5467

Open in FBI Vault (Part 18, page 134 of the PDF)

FBI 164-81, Vault Part 18 p. 134 (DB Cooper-5467), Form, serial SE 164-81-1705 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-18/pages/134

Transcript

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

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

FIRMLY - You are making several copies

Trip to be made on: [Destination:] Portland, Ore [Via:] M. [illegible] □ One-way Ticket □ Round-

[Name:] L. [illegible] ......... State OR[egon] [Checked here:] owner [Unless checked here:] [Insured's Signature:]

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

FIRMLY - You are making several copies

Trip to be made on: [Destination:] Portland, Ore [Via:] Eureka, Calif. □ One-way Ticket ☒ Round-

[Name:] [illegible] ......... State ORe. [Checked here:] owner [Unless checked here:] [illegible] Beneficiary is owner [Insured's Signature:]

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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: [Destination:] Portland, Ore. [Via:] Eureka, Calif. □ One-way Ticket ☒ Round-trip ticket

[Name:] TRINIDAD ......... State CALIF. [Checked here:] owner [Unless checked here:] Beneficiary is owner [Insured's Signature:]

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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: [Destination:] PORTLAND, ORE.C [Via:] EUREKA, CALIF. □ One-way Ticket ☒ Round-trip

[Name:] PORTLAND ......... State ORE. [Checked here:] owner [Unless checked here:] Beneficiary is owner [Insured's Signature:]

DB Cooper-5467

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