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~>a=~ <br />_ ins ~ :;:» ', <br />MINE REPORT <br />" Note-Please fill out this report carefully, write plainly and answer all questions folly. Be anre to <br />date the report and sign it. i7ll.,ou~t both-sides o~f the sheet. <br />----- ---- ----- Colorado, -------------------------•19--- <br />61i12EAU OF' 11fINES, STATE OF' COLORADO. <br />T. R. Henahen, Commissioner of Diines, <br />Denver, Colorado. <br />Sir: In aceordnnce with Section 4299, Revised Statutes, Colorado, 908, I submit report us follows: <br />Name of Company-The_~~~?~_~zt=~!j_ ~~Fh~~ . . <br />------- --= <br />Incorporated in the St a of_____________________ Q ~~'- <br />----- -------------- - <br />Principal ot>'ice _____ _ <br />C ~ (,/ i~ tip <br />Capital stock ___ f_ Shares, at :]; ~' 0~_ per share. <br />----- ----------------- - <br />II . Cam ,oy, <br />^i' ^°t'~I" Namo P. O. Addresses <br />.p,ra othenrb. - <br />bne It 61,nk <br />President ---. -. i~`-L~ ~~,7'//uj~-'---- - ---- ~llfftl_z~.cc~~--~--- -_ ~. <br />Secretary ~_TCi~_ _zz-cr~3%~ ~t_~?? ~?_~ ~?________ <br />Trenaurer -r=-----~-~-----------------`---------- ----------------------------- <br />Blanagor -~~------"- ~ ---------------- <br />----------°- <br />'T'itle of Pnrtnerehip__________________________________ <br />---------------------------- <br />Partners' \'ames P. 0. Address <br />If . ern, <br />or p,rtnmhlp, <br />all oat [hh <br />gore; otherwLe <br />Inn It Cl,nk <br />iltnmtgar------------------------------------ -------------------------------- <br />Names of Otvncre P. O. Addressee <br />If nrlther <br />~mp,ny nor <br />pe rlnenLlp <br />nil on[ tali <br />.p.re <br />Stute names oP claims: <br />""" ~Pntented <br />_.-- <br />nen in the ,_ ~____ <br />- ------ - - -- ----- ---- <br />------------ <br />.Compsn~. <br />Un ntentetl <br />-- <br />---------------------------------------------- <br />1'ot,•11 ucrea a ~~~ ___acres; unpntent,~d___=___~ ~________- ---acres. <br />g pntented_____~ _ ___-- <br />Do you own or lease these clnimet_____~~~_:~C'-'_"'-'`-=------------------- ---° <br />If you lease them give name of company or person Yrom whom leased______~___________._______-_ <br />... , _ <br />(Over) <br />