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Co-~tp,~~~~~ <br />MINE REPORT <br />ryi` ~ -y <br />~ y~ <br />Note-Please fill oat this report carefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fill oat both aides of the sheet. <br />Laye_C~ty,__~o19_____________, Colorado, __ I)ep~_I7,__23I3,- lg__, <br />BCRI'.:1ti OF hIINES, STATE OF COLORADO. <br />T. R. Aenahen, Commissioner of 1lfines, <br />Deaver, Colorado. <br />;ir: In accordance with Section 4299, Re •isedStntutes, Colors moo/, 1908, I submit report ns follows: <br />Name of Company-The __ _ __ ___/`~________ - ~ <br />'Incorporated in the State of______________________________________________________ <br />Principal ofSce -----------------------------------------------------------------.. <br />Capital stock _________________________-_ 5harca, at $__________-._ per share. <br />u a caTna~r. <br />nn,~t im• Aame P. 0. Addresses <br />.,.re: o:ner.w <br />lore H blank . <br />President -- ------------------------------------ - --------------------------- <br />Seeretarp ------- ----------------------------- <br />~Treasurer -------------------------------------- ----------------------------- <br />llfaneger --------------------------------------- ------------- --------------- <br />Title of Partnership-------------------------------------------------------------- <br />Partners' \umcs 1. 0. Address <br />---- -------------------------------------- -------------------------------- <br />I! a Erm <br />or par.,,.r.bro. <br />CI!uut thln ____________________________________________ _____________________.-____-____._ <br />qvr: o:Wrrlae <br />ia~• It Llank <br />i _. ______________ _ .._--__.._______-__...____-___.-_.. <br />~l ~fanagCr_______-.___________________________.. <br />Nunes of Owners <br />I~ ~r:~l~r ; ------------------------------- -- <br />,_ ,~:~ : teat <br />Pmurrnh ly, j <br />AI!ou: wy ___________________________ <br />gave <br />I _.__________________________________--..-_-._ <br />'~~IanagCl __._-___ ________.-___... -. <br />P. 0. Addresses <br />. Lih names of ela~me: ~_ _... -~ <br />Patented 1lnpatented <br />7!. Cothard Br y_cot,_]?lacer ,Jny__tI?Y~,_DurSly_,__ <br />r^loridc.-------------------------------- F. C. ,_ Jake Ba3aky_,T1'-t?'e21,1.~~g_i1_,. <br />------- <br />_P2Lehaasl `vireil_!_Herring_10_v_erbro ~l:,Schev_re., <br />Preston,P _eY~oe,ToY~~?ing-,Jen-,Noller, <br />- ------ <br />Lel{eta,fi&z1~or~re_,L!other-~R~_,Rc4TlQine . <br />----------------------------------- Beard,Hot Air ouP No oIto I2 <br />_ acres. <br />--- <br />g Patented-----------------------sores; unputented_--- <br />'total acres e 3 0 <br />Do yrou own or lease these elaimat---- 0?m---- --------------------- -- ----------- <br />3 ~~ lease them give name of company or person from whom leused_.- - -- -- - - --- - <br />--------------- <br />(Over) <br />9~ <br />;i <br />I, <br />I <br />II . <br />II <br />`I I I <br />I i <br />I <br />I <br />t <br /> <br />