Laserfiche WebLink
~~j <br />~//yID /~('// <br />t% <br />MINE REPORT <br />///QQO~~~/ - - _~_.-1 <br />~U/J~ ~~~ (/ II 1~ <br />``~ ~ /~ I t <br />Note-Please fill out this report carefully, write plainly and answer all questions Sully. Be s <br />date the report and sign it. Fill out both sides of the sheet. <br />~6G1-------------~ Colorndo ~'F~~ ~3----, 19-2' '' 1 <br />--- ----- r ---- -------------- <br />I3URF.AU OF 11TINES, STATE OF COLORADO. <br />T. R. Hennhen, Commissioner of Jlinea, <br />Denver, Colorado. <br />Sir: In accordance with Section 4209, Reeised Statutes, Colorndo, 1908, I suhmit report ne follows: I ~ <br />Name of Company-The---------------------------------------------------------- <br />Inrorpornted in the Stnte of______________________________________________________ ~ <br />Principal of£ee --------------------------~----------- ..-------------------------" <br />Cnpitnl stock _______________________-..__ Shares, nt $____________ Per share. <br />If ~ Comptor. I <br />ivy eat other.L. _ Name P. O. Addresses , <br />lure It blink <br />If . Orm <br />er partnmhtp, <br />011 out lhb <br />spar; athrrwlre <br />kn• It hluk <br />ff nellher <br />~~ may not <br />pert nrnhlpp, <br />CII out thlr <br />.prtt <br />President --------------------------------------- ----------------------------- <br />Secretnry --------------------------------------- ----------------------------- <br />'Prenaurer -------------------------------------- ----------------------------- <br />\innnger ---------------------------- <br />--------------------------------------- <br />'Title of Pnrtnerehip-------------------------------------------------------------- <br />Pnrtnrrs' ~nmcs P. 0. !lddress <br />1lnnngcr------------------------------------ <br />Nntnes of Q1rne ,~Q,q-tt~S <br />_ / <br />--- =~--~s~4/' ~ /--------------- -- - <br />--~°~--~~n'~~E____'------------- ---- <br />~A[anngcr---------------- ---------- <br />~Intc names of e]aims: <br />O. Addressee <br />~'W__~~`~ _._ <br />=-r_e__ <br />Patented Q ~ ~~Uupntentedy ~~ ~ ~ ~ Q <br />--- - ------- - r ,~ ------------------------- <br />----------------------------------------- <br />~~efL_u-ll1~ --------------------------- <br />--- ---------------------------------------------- <br />,terse. <br />Tolnl nercuge patented_________ __ ________ ___acres; uupntented_~~i+~f_~=~-~-~.~'Q'-' <br />------------------------------------ <br />1)o you own or Tense these claimst___ ------------ <br />lf you !case them ice nn a of com any or person from whom lensed________________________________ <br />(Over) <br />