MINEBK00158

• County: Park
• Document: Manager
• Suffix: A

he leasing com-
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MINE REPORT
idress Note-Please fill oat this report carefully, write plainly and answer all questions f
L date the report and sign it. Fill oat both aides of the sheet.
L!iQ„„-"''":;-- ~ ~'~~-~Ef-=-------• Colorado ~-~` ----~ f---, 1~J_~~
~~. 6UREAU OF MINES, STATE OF COLORADO.
- -- T. R. r :iesioner of ~T..ea,
-------------- DI ,. ~-
?t-~l!_?~1=. Sir: In e:.cordauce with Section 4299, Revised Statutes, Cotornuo, 1908aT~. ,, nn follows:
Name of Company-Tho----------------------------------------------------------
Inoorporated in the State of_______________________________________________..______
Principal ofBce -----------------------------------------------------------------..
Capital stock ___________________________ Shares, at $____________ Per share.
It . Comp.nT
all ont_thl. ,__ Nnme P. 0. Addresses
_ _ _ _hour shift.
_ _ _ _hour shift.
___ _hour shift.
____lloursllift.
____hour shift.
____hour shift.
____hour shift.
____hour shift.
____hour sllitt.
____hour sllitt.
____hourehift.
j-,----------
Y~'.l"-------
rkmen in the
---Compaq.
y~a-n-
,_
President -- -----------------------------
``' ~'~ 4` ~ $ecretar
-----------------------------
---------------------------------------
Trcasurer -------------------------------------- -----------------------------
lManager -----------------------------
---------------------------------------
'Pitlc of Partnership---------- ~ ------- - - - -- -------------------------------
~' Partners' Nnmcs P. 0. Address
Il.Elm ~~, ~C-'---.---
ar Mrtnrnhtp, ~
all one tab ---------_._-----------------------• --- ---------------------------------
.p.ce; otherwbr
lent It bl.nk
Sinnager-------------- ----------------- ---
/y~pNnmes of Ownerc~
e ndlher
omn.nr nor _______.._______
.. tnenhlpp,
~:Illr out thlr ---------------°---------------'------------
.p.n
~Ilrte names of claims:
P. O. Address
_-- -'-i--die _._~~G_ ~_
Patented Unputented
---- C~j!-'-'?'-~L------------
- ------------------------------------------ -----~~~__?r_~---------- -----
---- ------------------------------------------
'I'atal nerenge pntented___________________` `acres; unpntented____.___~7 Q__.___....---.acres.
~---
-- ---
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!f from whom lenacd___G.2 __.~~~~~ - --
I)oSou lease tl em gi •elnnmelofmcompany ar p~n ~`=---L`---------------_---_- _------_---
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ally. Be sere to ~ 1