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/ "~ <br />~ Y ; :,~~u <br />MINE REPO T <br />Note-Please fill oat this report carefully, wrtte plainly and answer all gneationa fully. Be sere to <br />date the report and sign it. Fill o~nt~b~o~th~ aides of the sheet. A _ / ~7 <br />__-._____~~==`-!='-~`=r't-~-------, Colorado `~.(~!U J ------, 193 <br />BUREAU OF b1]NES, STATE OF COLORADO. <br />T. R. FIenahen, Commissioner of clines, <br />Denver, Colorado. <br />Sir: In accord¢nce with Section 4299, Revised Statutes, Colorado, 1908, I submit report na follows: <br />Name of Company-The---------------------------------------------------------- <br />Incorporated in the State of______________________________________________________ <br />Principal offiee -----------------------------------------------------------------.. <br />Capital stock _________________________.._ Slmres, at $__________-_ per share. <br />u . com w. <br />en not tgl. Name P. O. Addresses <br />.pect• athetwW <br />~ ~vt ie hLnk <br />a . ann <br />cr D•rtnmhlp, <br />0I1 oul Ihl• <br />tP•tt: other~W <br />Ln't It 61•nk <br />u ntuner <br />^omp•nf nor <br />mm~61 , <br />til not ehQ. <br />.r,a <br />President --------------------------------------- ----------------------------- <br />Secretary --------------------------------------- ----------------------------- <br />Treasurer -------------------------------------- ----------------------------- <br />1lfannger --------------------------------------- ----------------------------- <br />Title of Partnership----------------------------------------°-------------------- <br />Pnrtncrs' Names P. 0. Address <br />-------------------------------------------- --------------------------------- <br />____________________________________________ _________________________________ <br />linnngcr----------------------------------- -------- ---------- ------------- <br />----------------/f----~--~--~--~--^~------------ ------------------ ------------- <br />Names Owners P. O. Addresses <br />_ . _O-Y_~iYrm,-ate N_~___.r-,~..co <br />------------------- <br />-------------------------------------------- --------------------------------- <br />State n¢mes of claims: <br />-'---- <br />______ Patented / Unpntented <br />nen in the !(~u~!i_' s~SG ~t~'~/ ~ Y ---------------------------------------------- <br />---------- -------------------------------------------- ---------------------------------------------- <br />_ __acres; unpatcnted__..____.---------------- -..acres <br />6 Patented~000 ll'R?y~Q _ <br />'1'ot:A nerea a <br />-- <br />_CosrPaW Do you own or leaso these claimat___-----------------'-"°'°---------------- - <br />If you lease them give name aP company or person Yrom whom leased___________________-.------------ <br />_- -------------------------------- (Over) <br />