MINEBK00334

• County: Teller
• Document: Manager
• Suffix: A

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r'^rznt~ %~~1 ~ I?~~t ~~ ~~~
MINE .REPORT ~' ~~~
Note-Please fill out tbis report carefully, wtYte plainly and answer all questions folly. Be sure to
date the report and sign it. Fill out both sides of the sheet.
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-------~--C/-~----------------------. Colorado '~ ~ _, 19L_a~
BCli ;AU OF' 11[II~'ES, STATE OF COLORADO.
T. R. liennhen, Commissioner of i\Iinea,
Denver, Colorado.
Sir: In accordance with Section 4299//~~R~~evise~~dStatutes, Colorado, 1908, I suhmit report us follows:
Name of Company-The1L?~e~J_~o~~r'i1 J~'~-e•/ ~_ jF-~ ~~
(Incorporated in the State o ____ ~~" ~ "-- ~- ~-(~~
-- --------------------
Principal office
~ -----0 O ----O-O -*--- -- - ---- ---- -- ~-o ..------
,apitnl stock _Ji_Q___ _,_~____ hares, ut ~,=_______ er
u. cam .nn . ---.- .._ ~ _ p share.
!1. ~~, .r.. -. ,
.w«: ~m...l.. _ P 0. Add saes
Iov It Ll.nk ~~ •
President - - -- - - - ---- ---------- - -- --
Secrctary --- ~- - - _ _---- ------ ~ - ---- - -
- --
'I'rcusurer - '- -- - --------- ----------- ----- --- '~--------- --
----
\Innugcr ~•
r' - ------------------=
-----------------
'1'itlc of Purtnorehip__________ __ _ ._ ____
Purtm rs' \ann's Y. O. Address
Ir . r„~, ~ _ _ _
or tm ~nblD.
I.~~~•.i „t L.rwlw
t Lhnk
~1llnllgtll'_--. _. - _. _....__.
r iVnnlex of Owncrx
i
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.,:,,..1;;1:
~ --
~~ 1luuager _ .. - _ _
`i~~ ~ ulunex of claims:
1'. O. Addrcxxex
a~Putunted~ _/ tl,kt,,,t.,r,t~t-
Q/ ~~~ ~ ~ ~
G,"`.~~/ I'Q
V ~ ~.-~-L.- - - ---- ---- _ _ - - ~--- -- ...
'ful^~ :ua•cu R~' Puluuted-. _ _l ~_. _ -a.rex; uupulcutcd_ --
ucres
Uu You own or ]wlau those claiulst_._._ Q,e-v--~.
-- _ --
It5'~u L~:Ixe them give nu Ie of cowpuay r pursou Yrmu whom Icuxcr! ~~~ ~d--Q `^..~ ~fj
!/ - - ~ - -
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