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~pLrD-~7 <br />MINE <br />i r ~ <br />_ w`. tJ <br />REPORT <br />~~ ~0 <br />:540 <br />Note-Please fill out this report carefully, write plainly and answer all gneatiom folly. Be sere to <br />date the report and sign it. Fill out bath aides of the sheet. 77~~~~,, ~ ~ <br />-----------------~ Colorado,C~~1_~~~~-. 19~aS~- <br />f3URF.AU OF MINES, STATE 0 COLORADO. <br />T. R. Iienahen, Commissioner of 1lfines, <br />Denver, Colorado. <br />Sir: <br />u . com~.or. <br />ml o,t 1. <br />.pa• oNerr,IM .. <br />Ion IC blot <br />President <br />Sccretar~ <br />Treasurer <br />'.lfanagcr <br />~f <br />tf <br />v <br />of Pnrtnereiup------ --- ---------- ----------------- <br />Partners' Names P. 0. Address <br />u . e[m <br />or grtomhlp, <br />Ell oat thb <br />tp~n: o[herr4a <br />Iene It bLok <br />------- <br />Manager--------------------------- <br /> <br />Names of Owners P. 0. Addresses <br />------------------------- <br />------------------ <br />If eeithv <br />rnmp~o7 [wI <br />p~rtoenhlp~ <br />GII oot llil~ <br />ry~n <br /> <br />_________________________ _ <br />___________________________________________ <br />~~ <br />___________ <br />Dfanager --------------------------- <br />State nnmea of claims: p~ ~'~ 17npnte/nted <br />. ~ ~ _ s . '~,-sue --------- <br />--- <br />- .~ .u_-L,~._.~we~.,..r- ----- <br />~~-==_ == =-s------- <br />------------------------------- ~ S ---------------aurae. <br />--- <br />---- <br />Total acreage patented______~-~ --~------- res; unpatente ___ <br />Do you own or levee these claimef__~r~'-'-~~----------- --- -j~ --"--~ ------ <br />)4 you lease them give name of company or person from whom leased_ ~---------.-~--c--~---~------- <br />--------------------------------------------~pven) <br />In accordance with Section 4299, Revi~sed~St~ntutea, Colorado, 1908, I submit report as follows: <br />----- <br />--- <br />Nome of Company-The~i'~~ ~s~-'~---------- --- --- ~ ~ -----= - <br />---- <br />Incorporated in th tote of_____ _ __ - -n~= °~"~--------------------'--' <br />Principal office __~ "o Q '-------------------• <br />- - ----- ------ <br />• ~ O O O_ O _____ Shnrce, nt 41 _ _____ per share.~~ <br />Capital stock _-___ ~__-- ~ <br />---- n n AA.i,.mena <br /> <br />