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Last modified
1/6/2009 10:21:55 AM
Creation date
11/18/2007 12:08:13 PM
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Mine Books
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Clear Creek
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~OTIT't~ ~~ ~6 ~?6~i, <br />,~ .:) <br />k ' MINE- REPORT <br />n <br />Note-Please 8ll out this report carefully, write plainly and answer all gnestlons folly. Be sere to <br />date the report and sign it. Fill out both sides of the sheet. <br />7 1 r <br />---------------------------------. Colorado, -------------------------,19--- <br />[3CRPAU OF ?vIINES, STATE OF COLORADO. <br />T. R. lienahen, Commissioner of Jlines, <br />Denver, Colorado. <br />Sir: In necordnnce with Section 4299, RevisedStatntes, Colorado, 1908, I submit report as follows: <br />ATnme of Company-The------- ~--~- ---- --------------------------------------- <br />• <br />Incorporated in the State of___ ____ -------- ---- -------- <br />e-+ wr-- <br />Principal office ---_----- ----------- ------.. <br />Capital stock ______________-- °--- ---Shares, nt ~___:! _____-_ per share. <br />u .cum .nr. . P. 0. Addresecs <br />en unt tgl• Anme <br />ntnm; othenrL. ~ <br />I~~o•. It hl.ok <br />President ---------------------------- <br />--------------------------------------- <br />y ------------------------------- ---------- ---------------- <br />Seeretar -----~-- - <br />iTreasurer ---------------------------- <br />I <br />'\Innager __----- --------------- ---- <br />Ur . nun <br />yvnnrnhfv. <br />NI aut [61. <br />,p~c, .: otherwl.e <br />I • It hl.nk <br />Title of Partnershi~~-~~- ------ ----- --------- <br />P---------- ---- - ---- ------ <br />_-Partners' \anl,.4 -----P. O. Address <br />~ - -- <br />J -------------'---- -~----.._._.._.._- <br />I <br />____- _ <br />l~ anuger____________ _____________ <br />Names of Owners <br />It neither <br />nnp.nr oor <br />Imrtuerehi <br />all uu[ WI. <br />•pnce <br />P. O. Addresses <br />__. __ <br />`~funager---------------------------- --- <br />- ~tlrtc aames of claims: <br />- Patented ^npatented <br />~ the ------------------------- <br />--------------------------------------------- <br />-____ _ucres. <br />-- -- <br />---------- <br />'1'utul acres a ___acrea; unpnten a __-_-- <br />B Patented---------------------- <br />pany. Do you own or lease these claimet------------------------'-"- <br />____ !f you lease them give name of company or person Yrom whom lease __--_-- <br />----------------------------------------- <br />---- (Over) <br />~~ 1 <br />
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