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------------------------- <br />P. 0. Address <br />------------------------- <br />------------------------- <br />------------------------- <br />------------------------- <br />------------------------- <br />Nnmes of Owners P. O. Addresses <br />nrtnm6lp~ ____________________________________________ <br />11 odthn <br />ell out tlW ____________________________________________ <br />~vtt• <br /> <br />-:,, ; ~ ~- <br />... - v-_ . _.. ti J oo <br />^v~ <br />MINE REPORT ~~~" m <br />~~ <br />Note-Please fkll out this report carefully, write plafaly and answer all gneationa folly, Be sere to <br />date the report and sign i( t,, Fpill sat bath efdes of the sheet. <br />~9 .. ,, .~ <br />------` ~ ----- ----- - '~. Colorado, ---=-- -~ 19--- <br />BUREAU OF MIIQES, STATE OF C LORADO. <br />T. R. FIenahen, Commissioner of 11lines, <br />Denver, Colorado. <br />Sir: In aecordaace with Section 4299,~visedStntntes, Colorado, 1906, I submit report ae follows: <br />Name of Company-The--------- -- -- --- - ---~`~~=?~~~~' <br />Incorporated is the Stasf~ of_____ _ __ ___ _____________________ _____ ' <br />Principnl office -~~-----//--- -----'-- --- -- ~---- ---- -=~-------------- <br />a~cam Capital stock ~!1121~Qs~f1___________Sharee, at $_~~____ per share. <br />en ooe ~ ?yy m ,~ 0. Addresepey <br />ry.ee: om.r.w ~//// ~~ <br />km It bhuk / ~ - <br />Preaident ~_____ _ _ _ __ ___ _________ ___ ~- <br />S ret~rY .[~~~ - -- - ----- -- C - ---- - - ------ <br />Manager --------------------------------------- <br />ills of Partnership------------------------------------. <br />Partners' Nnmes <br />------------------------------------------- ------- <br />-------------------------------------------- ------- <br />------------------------------------------- ------- <br />:nnngcr----------------------------------- ------- <br />h[anegcr------------------------------------ <br />State names oP claims: <br />j Patented ~ j Unpatented <br />~r~V~~~'t~ _~V~~------------------ -------- ------ -- <br />------------- - --- <br />----- <br />Total acreage pateated_~~~___acrea; nnpatented___ __________ <br />Do you own or lease these claimst__Cr~l_?'1___________________ <br />If yon lease them give name of company or person from whom lead <br />------------------------------------------------------------- <br />(Over) <br />_=====scree. <br />~IA <br />