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,ate. <br />ft. <br />ft. <br />ft. <br />ft. <br /> <br />~/ ~ ~~ <br />~~ 94 <br />MINE REPORT <br />Nate-Please fill oat this report carefully, write plainly and answer all gnestions folly, Se sore to <br />date the report and sign it. Fill oat both aides of the sheet. <br />---------------------------------+ Colorado, -------------------------,19--- <br />BUREAU OF MINES, STATE OF COLORADO. <br />T. R. Henahen, Commissioner of Iviines, <br />Deaver, Colorado. <br />Sir: In accordance with Section 4299, Revia Statutes, Colorado, 1908, I submit report as follows: <br />Name of Company-The----~C~------------------------------------ <br />Incorporated in the State of_______________y~_______________________:________- <br />Principal o~ce -----------------------------------------------------------------.. <br />Ir. cam Capital stock ___________________________ Shnrea, at $____________ Per share. <br />^11oue r~ Name P. O. Addreeaes <br />ryaer; orbrrwl.. <br />Inrr It blot <br />It a arm <br />ar Dartoen6lp, <br />eu oar rev <br />rpatt; othenrW <br />leave IL blot <br />If orliber <br />nmDanr Dar <br />Prrtnrnhfyy~ <br />IIII out tiW <br />rPara <br />President --------------------------------------- ----------------------------- <br />Secretary --------------------------------------- ----------------------------- <br />Treasurer -------------------------------------- ----------- <br />------------------ <br />Mannger --------------------------------------- ----------------------- <br />'Title of Partnerehip--------------------------------------------------------- <br />Partners' \nmes P. O. Address <br />____________________________________________ <br />Manager------------------------------------ <br />~~~~---NamQe~~of w e~re~/yL~ <br />-------------------------------------------- <br />____________________________________________ <br />_ ____ ___ <br />1linnnger_-~-~- ----- - ----------- <br />State names of claims: <br />/ Patented <br />1~ ~L~t1~'"~""''i ---- --- -- ------- - <br />--------------------------------- <br />P. O. Add saes <br />--------------------------------- <br />Unpntented <br />--- - --- -------- ------------------------ ------------------- <br />-------------- ------------------------------- <br />Total acreage patented___~~_________acres; nnpatented_________________ <br />Do yon own or lease these claimat------------------------------------------------ <br />If you lease them give name of company or person from whom leased_________________ <br />------------------------------------------------------- <br />(Over) <br />-------------- <br />_________aeres. <br />