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~OL:L u~ ,~,~. r ~r:!.~L <br />/ ;!~~ <br />MINE REPORT <br />Note-Please fill out this report carefully, write plainly sad answer all questions folly. Be sere to <br />date the report and sign it. Fill out both sides of the sheet. <br />,~"G~',.'-----------------. Colorado ~~ ~ ~------ ---~ 19!_i <br />i3URF.AU OF IvfIA7~, STATE OF COLORADO. <br />T. R. 13enahen, ommiesioner of :~Iinea, <br />Dencer, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />9r <br />.~ , <br />Name of Company-The__c~'_)u?'_"~~" ~ ___y <br />-~------- r4ly.~a~! --G-~----- <br />~ ~~ ---~ <br />Incorporated in the State of__ Ls-ts________..___________________________-._ <br />-------- <br />Principal office _____;~K ______ __________. <br />~; <br />Capital stock ___V_`_'°a°'_________-_-_Shnres, nt $~__________ per share. <br />If a Camp.n), <br />n11 nut t lv Name p PF~. Addressee <br />•v.K: nmer.w 7 <br />I.ne It bivnk ~C~,Q Q ~~ ~O ~ ~t J~_ _ (x <br />President --- - ----------------- -----s1-- -------=-!------ -- ~ <br />~-------~^----- 7 ~G,~. <br />Secretary ~ -- ---- ec_ ~_~_!~"_~"-.a'..,------- /~--~- ~'----- <br />Treasurer r4~ --------------- (/ __-~"°__~lr_•_-n~c ------------- <br />Dfanager -~ a- -------------- ---------~°------------------ <br />of Partnership------------------------------------------------- ---------- <br />Partncrs' Nnmce P. 0. Address <br />I[ .arm <br />r Dvrtn.nhlp, <br />All ml tbiv <br />givrr, ovhenrl.e <br />Lv~• It blank <br />I____. .. __-__-____ _-_-_-__.-_.-__-___- <br />~dlanugcr - - ---- - -- -- -- --- <br />Names of Owners <br />I! aril hrr <br />' vnT oar <br />I ~rti~.nblp, <br />T•I ~nt thl. <br />.,,. . <br />Y. 0..1dd msses <br />__ <br />ntanager__ - ------ - <br />~t:n~ umnce of clnima: <br />~e Patented ~ ~i~~e~tcd <br />~ i <br />.CV3-• -r. ~ ,- <br />'ft,t;~l acreage patented%y~2e~s~./.~ +.I~ _ _acres; uupatentedf~"O"`-"'~~ /, <br />Do you own or ]ease these claimat____ _Q??" [~ // _ - <br />lt you knee tbem give name of company or pemon Yrmn wl,um Irased__- <br />--------------- <br />--------- ---- -Over) <br />--•-fi,. <br />r~ , <br />^rgl <br />I ~ <br />;, <br />.~ , <br />V <br />• I <br />,l <br /> <br />~ ~~ <br />I <br />,~I <br />,~ I ~, <br />;~ ~!~ <br />