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\ I~rt~ ~ <br />the leaeiug com• ~~~ <br />MINE REPORT <br />ddress <br />-------------- <br />r_ ___hour shift. <br />r_ ___hour shift. <br />r____llour shift. <br />r____Ilour shift. <br />_ __ _hour shift. <br />____hour shift. <br />____bour shift. <br />_ _ _ _hour shift. <br />____hour shift. <br />____hour shift. <br />____hour shift. <br />~rkmen in the <br />Note-Please fill out this report easefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fill o~nt both sides of the sheet. / <br />~/!i_`_!_I --------. Colorado, -- -- ~!_~19f~ <br />BUREAU OF bTINES, STATE OF COLORADO. <br />T. R. Hennhen, Commissioner of Diines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />if • Compaq, <br />ell out l It <br />epaet; othetwlaa <br />Irate It blank <br />If . arm <br />or Dertamhlp, <br />IIII out [hit <br />ePere; otherdw <br />I<ave It blank <br />I! neltber <br />comPenl Dpt <br />pvrtnenhlp' <br />all out , D. <br />meet <br />Name of Company-The---------------------------------------------------------- <br />Ineorpornted in the State of------------------------------------------------------ <br />Principal oE6ce -------------------------------------- °--------------------------.. <br />Capital stock _______________________----Shares, nt $__________ _ Per share. <br />Name P. 0. Addresses <br />President --------------------------------------- ----------------------------- <br />Secretary --------------------------------------- ----------------------------- <br />Treasurer -------------------------------------- ----------------------------- <br />Dianagcr --------------------------------------- ----------------------------- <br />- ` QL ,~y~ <br />'Title of Partnership---~~~~°==-`=---/---~~-V- `=---~v~ ---------------- <br />~ Part crs' \nnl ~ P. Address <br />G~ ~ LZv-y---- --- ---~ --'-~-~ 1 ---[°~ v <br />-- ,•F- ---- ------ <br />_~_ ~ ~f~ <br />- - f -- <br />_______________/ ,t.//// _______________..___ __ <br />ilTnnager------~---'/---^------------------ ---------------------------------- <br />- nmcs Owe P. O. Addressos <br />---------------------- <br />Dfannger--------'-- ------------------------------ -- <br />Stutc names of chime: <br />Pate/n~ted~ ~ ~ Unpatented <br />-----/-.~rr.Cc~ ` ~------------------- ---------------------------------------------- <br />---------------------------------------------- ----------------------- <br />--------------------------------------------- ------------------- <br />----- <br />'Dotal acreage patented_____ ~/ acres; unpatented_______-------------- - ---acres. <br />>'y ----Q--- <br />Do you own or lease these claimsT______.~`-~`~-~---------`--"-------- <br />-- - <br />lf you lease them give name of com ny or p rson Prom whom lene~ -------------------- -- ------- <br />---- <br />-----------o- - - <br />• (Over) <br />