Part 55, page 105
FBI 164-81, Vault Part 55 p. 105 (DB Cooper-23248), Form — cooper.theunsolved.net/parts/Cooper-Part-55/pages/105
Transcript
The scan is the source; the transcript is machine-generated from it.
[illegible] ADULT [redacted] ATTENTION . [illegible] Date Only D [illegible] [illegible] [illegible] cafe [illegible] [multiple redacted blocks - b6, b7C] [illegible] Community [illegible] [illegible] [illegible] contact [illegible] [illegible] marks [illegible] [illegible] [illegible] and [illegible] — [illegible] [illegible] [illegible]
[illegible] W [illegible] 10 [illegible] of [illegible] [illegible] [illegible]
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ABSOLUTE IDENTIFICATION FORM
Check Only One Please How did you learn of [us] (Check Only One, [illegible]) [illegible] [illegible] ☐ "A Spirit Is [guess: Coming]" [illegible] [illegible] Coupon[s] ☐ Report to [illegible] [illegible] [illegible] ☐ Colins Show [illegible] Only if [illegible] give name of[illegible] ☐ Review [guess: Paper] [illegible] [illegible] [illegible] ☐ [guess: World] Court [illegible] [guess: directly] [illegible] [illegible] [illegible] [illegible] ☐ Found [guess: Notice] — [illegible] [illegible] ☐ Word of Mouth O[illegible] . O[illegible]
HOW DO YOU WANT TO CONTACT? ☐ Phone ☐ Car ☐ Bus ☐ Other [illegible]
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ADJUSTMENTS OR INCOMPLETE TRANSACTIONS AND COMPANIES [illegible] [illegible] [illegible] if for any physical information or chronic ail[ments] [illegible] [illegible] [illegible] [illegible] [illegible] or have corrective lenses, and that I have [illegible] [illegible] [illegible] [illegible]
[illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible]
(a) Nervous disorder (b) Diabetes (c) Kidney or related diseases
Date 3 - 1 - 71 [illegible]
[illegible] 5 [guess: Staff] — [illegible] [guess: four] [illegible] — READ AND COMPLETE ON [illegible]
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DB Cooper-23248