FormMutual of Omaha policy-machine insurance application cards, Portland 11/24/7124 November 1971page 1 of 2
fbi_formLegibility: medium

Part 18, page 137

DB Cooper-5470

Document date 24 November 1971

Open in FBI Vault (Part 18, page 137 of the PDF)

FBI 164-81, Vault Part 18 p. 137 (DB Cooper-5470), Form, dated 24 Nov 1971 — cooper.theunsolved.net/parts/Cooper-Part-18/pages/137

Transcript

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

[redacted name block - b6/b7C]

Boise Sears Portland Boise

Nov 24 71

[illegible faint text at bottom of section]

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[redacted block - b6/b7C]

PORTLAND PORTLAND SAN FRANCISCO

11/24/71

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IMPORTANT THIS CARD IS TO BE DEPOSITED IN SLOT DESIGNATED ON POLICY MACHINE

Application to Mutual of Omaha Insurance Company Insured Name [redacted - b6/b7C] Benef. Name [redacted - b6/b7C] Street ........................ City.. PORTLAND ............ State. ORE. Point of Departure PORTLAND .................. Desti- nation mpls.. Minn. ......... Trip to Be ☐ One-way ☑ Round Made on: Ticket trip Ticket Date and Time of Purchase ... 11.. 24.. 71 ........ Insured is owner ☐ Beneficiary unless checked here: is owner. Signature of Insured ..[redacted]............... 844M App

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T33AV-M2 DB Cooper-5470