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

Part 18, page 136

DB Cooper-5469

Open in FBI Vault (Part 18, page 136 of the PDF)

FBI 164-81, Vault Part 18 p. 136 (DB Cooper-5469), Form, serial SE 164-81-1705 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-18/pages/136

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

[Depar]ture: Portland [illegible] Trip to be made on: ☐ One-way Ticket ☒ Round-trip ticket

[Dest]ination: [guess: Medford] [illegible] [Purch]aser [illegible] [Insu]red's [illegible] [Bene]ficiary [illegible]

[Insu]red is owner unless checked be[low] [Insu]red's Signature: [blank]

[guess: Bon[illegible]] State [illegible]

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

FIRMLY - You are making several copies

[Depar]ture: Portland Or. Trip to be made on: ☐ One-way Ticket ☒ Round-trip ticket

[Dest]ination: West [guess: Plains] Mo. [Purch]aser [illegible] [Insu]red's [illegible] [Bene]ficiary [illegible]

[Insu]red is owner unless checked he[re] [Insu]red's Signature: [blank]

by [guess: Robert] [illegible] State [illegible]

b6 b7C

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

FIRMLY - You are making several copies

[Depar]ture: Portland, Or. Trip to be made on: ☐ One-way Ticket ☒ Round-trip ticket

[Dest]ination: Honolulu [Purch]aser [illegible] [Insu]red's [illegible] [Bene]ficiary [illegible]

[Insu]red is owner unless checked be[low] [Insu]red's Signature: [blank]

by [guess: Thas] [guess: Wells] State Ore.

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INSERT THIS END FORWARD

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

FIRMLY - You are making several copies

[Depar]ture: Portland Or. Trip to be made on: ☐ One-way Ticket [illegible] Round-trip ticket

[Dest]ination: [guess: West Plains] [illegible] Mo. [Purch]aser [illegible] [Insu]red's [illegible] [Bene]ficiary [illegible]

[Insu]red is owner unless checked he[re] [Insu]red's Signature: [blank]

by [illegible] State Or[e].

b6 b7C

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DB Cooper-5469