FormFD-340 receipt for four copies of a picture from Renton, Washington (serial 435), with attached copies12 October 1972page 5 of 5
otherLegibility: low
Part 84, page 178
Document date 12 October 1972
Open in FBI Vault (Part 84, page 178 of the PDF)
FBI 164-81, Vault Part 84 p. 178 (DB Cooper-37090), Form, dated 12 Oct 1972, serial SE 164-81-1A (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-84/pages/178
Transcript
The scan is the source; the transcript is machine-generated from it.
[guess: Ag.n]
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DB Cooper-37090
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164 8/-1u (435)