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~~~~ v~s'1-~ ~ ice` ~G <br />the leasing eam- MINE REPORT <br />.~ ~~,~ <br />ddrese Note-Please fill out this report carefully, write plainly and answer all questions fully. Be sure to <br />1_~~_~_-S_~_-~_ _-~.c•_p date the report and sign it. Fill out both sides of the sheet. <br />h <br />1 ~-` ~'. <br />___ - ---- -'------ -- - - ~-• Colorado, __!_ ~J_---1------~ 19~.h, <br />------- <br />3CRF,AU OF bIINES, STATE OF COLORADO. <br />------- <br />-------- T. R. l;enahen, Commissioner of Jf[nes, <br />--------------- Deaver, Colorado. <br />t-- --- Sir: In aecordaace with Section 4299, Revised Statutes, Colorado, 1908, I submit report ns follows: <br />_ Gl. y n ~ _.Q- <_ q ~ .ivy,, ~71_•__~~_~-~-- <br />Name of Company-The_______ ~ ---- <br />--------------------------------- <br />^__.y1jQ_- Incorporated in the State of___ __ __- -. ----~--',-~-.Q-,~----- <br />----------~ lbC <br />Principal office ~~~--~-_-~~(q,D__QRC~<l~!r---~ - e ~---------r-- <br />JCapital stocc~~oorooo___________Shares, nt $_~~________ Pcr share. <br />o.cen r. -..---P O. Addresses <br />eu oct t~ Name <br />r----hourshift. ,lwR:oth...w ~. N. ~n b <br />Ln'r a blot <br />Pres[dent -"---` r -r <br />~r----hour shift. -~--~- ~--y-~,-----p------J------------------- <br />r____honrshift. Secretary __-___--- <br />~f rr ~ <br />r___-hoar shift. ITrcasurer _-II------------- - -----"----- ------- <br />~-~t --- -- -------- <br />r____hourshiti. I`Jfannger ~=-!-'`•__~--------------- ~~'~-7-'~-------- - -- <br />r____honr s}iitt. <br />-- --- <br />r____hourshift. (Title of Pnrtnerehip---------------------- ------------------------~--~- <br />Partners' Names P. 0. Address <br />r____hour shift. <br />--------------------- <br />r___-hourshift. --''--- -------------- <br />r----hourshift. ----- ----- -- -------- <br />If r Erm --------. _.. _ <br />r__--hourshift. cr wrmR.wv. -------------~ <br />n!1 out th6 <br />ry•rr; otherdr I _________..__..__________ <br />__ iw•r 11 blot I _-_______. _.._ __-.-_ <br />- -_ <br />~~~filna6Cr __. __ ______.._________.._ <br />_____________ <br />-------------- r Nnmes of Owners I'. O. Addresses <br />-'----- <br />---- I --- --~~--~-- <br />I} OfIItIR - - <br />------------- ~~:,,.or ~r j -- <br />_-_ P•nnrnhly. ___..-. ... -.______. _______. - <br />G!l out tbL -_--.--_____________________________. <br />________ ~ rVrd _ _- _ _ <br />~,.p,Q.u.~ ~tq ~ _ --- -----------.. <br />--- <br />---- <br />1 - ---- <br />-- -- <br />-- -- <br />---------- I ._ ------- -. ..- <br />-_ <br />1lnaager _-- -. - ---_.. - <br />~~0_ <br />~~. <br />vorkmen in the <br />y-~--Company. <br />FtaL: names of claims: <br />/ Patented <br />a v_y.,~ ~~~..b.-,,x_1.1 t~_/ _ _.-- <br />~ar~ C~--P'-~-s.--- -------- <br />h--- <br />'1'olal acreage patented_Lv--'--- <br />Do you own or lease these claimst___ <br />if you lease them give name of comps <br />Unpntentcd <br />----------- <br />acres <br />____acres; unpatentc ___._- <br />-----_- <br />--~'1-_"---------- <br />------- <br />_.._ <br />oy or person irau tehom rnac _-~ -- - <br />------- -~pver) <br />