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• , r <br />~- - _ MINE REPORT ~~z <br />Note-Please flII out this report carefully, write plainly and answer all gneations folly. Be sere to <br />. date She report and sign it/. Full out bo~th~ aides of the sheet. <br />- '~/~~[-.%"1~-u~f%~----~ Colorado, -,-c2- ~----. 19 / S <br />BUREAU Oh' i1TINES, STATE OF COLORADO. <br />T. R. Ilennhen, Commissioner of .lIiaea, <br />`~~ Deaver, Colorado. <br />~~ / Sir: In accordance with Scetioa 4299, Reviacd Stntutca, Colorado, ~1908,~I submit report na follows: <br />Nnmc of Company-The---~.;,.~~_~~X~~- ~ ~-- <br />Tncorpornted in the State of_---- _ 9atJ~r4~~----------- <br />Principnl otTice _____~i_C~llt~„a.e`___ _ <br />Ir.compp.nr. Cnpitnl stack _____~P_S!0•O0O____-_Shares, nt 4-~ ~`______ per shore. <br />ail out [hb <br />t_ i°::: ie°ni."i ~° - Nnme P. 0..lddresses <br />t. President __~J~~.£i_. _ o _ ~~~ ~(~~ -/~r. <br />Secretory __iV/~t-y~a,,,,,J- ~ <br />rr ------ <br />-------- --- -- - - ----------- <br />- - --- ------------------ <br />:. 1lnnagcr Gt - -- -- ------~---------- "" ~- <br /> 'Gills of PnrtnerahiP-------------------------------------------------- <br />,. Parlours' Xlunes P. 0. Address <br /> if. arm -------------------- <br />------------- <br /> or p.rtnen6lp, <br />" all out thl. ~ ______-.____. ___________________________ <br /> <br /> Inre It bl.nt <br /> - ' - _~r ________.-_____________ <br /> lSlnaagcr------------------------------------ -------------------------------- <br /> r Names of Owners P. 0.:lddresses <br />I <br />~- ________ <br />y ______.___ ___________________-.______ <br />_______ <br />~./~ If nellher ____________________________________________ <br /> rompmr nor <br />pertnenhlyy, <br /> <br />J <br /> all aut thl. ____________________________________________ _.________________________________ <br /> m.oe <br /> 1[nnngur----------------------------- --------------------------------- <br /> Stntc nnmcs of claims: <br />~/, Pat`ented <br />.l~2 <br />Unpntented <br />-r----------------------- ---- <br />- -- ------------------- <br />T ~R'-' <br />_ ,. <br />---------------------------------------------- <br />--- ------ - <br />-- ----- - <br />'I'otnl acreage patented ds.. ~ acres; unpatented___xc_ _ ___acres. <br />Do you own or ]suss these claimef_________~ ___------------------------- <br />if you lease them give name of company or person from whom lensed________________________________ <br />---------------------------------------------------------------------------------------------- <br />(Over) <br />o~~ <br />.il <br />_.., <br />I <br />I <br />