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(,', , <br />MINE REPORT ~i <br />Note-Please fill out this report carefully, write plainly and answer all questions folly. Be sore to <br />date the report and sign it. Fill oat both aides of the sheet. <br />J n. <br />l~- ~i t ~ `~' ' - ' ~' _-___, Colorado, ~~__ ~ ~f <br />- --------------- ----- -------------+ 19--- <br />BUREAU OF DIINES, STATE OF COLORADQ <br />T. R. Rennhen, Commissioner of Mines, <br />Denver, Colorado. <br />Sir: In accordance with Seetion 4299, Revised Statutes~Colo~r~ado, 1008, I submit report as follotve: <br />Nnmc of Company-The___ ~ '~_ ' ' ` ' ~ ` • ' ~~ ~ ~ " ' ' `- `~- <br />----------------G --------------------- ------ <br />Incorporated in the State of______________________________________________________ <br />Principal office ----- -------- -------- ---------------- ---------- <br />- -- - --- <br />Capital stock ___________ ~_• __._~ Shares, at $____________ per shore. <br />If a Cam any, <br />ea oat tgt. Nome <br />.p.ro• otheew4. ..~. P. O. Addresses <br />tare It Dlank <br />If . erm <br />or DartnenNp, <br />ea out thla <br />.pare: otherwl"a <br />love It Dlank <br />If nellher <br />company ~npor <br />ennaut~tnla <br />.paro <br />President ___________________ <br />SCCLCtary ___________________________/,+ <br />_ _=_S~~_ __________________________ <br />/! <br />Treasurer -------------------- - -- - r <br />3fanagcr <br />Title of Parlnership____________ <br />Partners' V;nues P. 0. Address <br />---------- ---------------------L___.------ <br />-----------------------------------~-~1=~ ---------- <br />--------------------- -- <br />~IIIIIagCr______.._____________________________ ________ <br />_________________________ <br />.I~Tnmes of Owner ~ P. O. Addresses <br />.__~______ ___s_ __________________ _____ ___/_ '~____ ` ____ ____~_ <br />____.. <br />~[annger ____________.._______________________ _________________________________ <br />State names of claims: <br />~ Patented <br />Unpntenten <br />Total acreage pntented______________ _______acres; unpatented__________ ucres. <br />---- <br />Do you own or leaso these claimst____ ~ t ' "-"'- ~- -•' -``---~--- <br />-------- ------1 <br />If you lease them give name of company or perepn from w]eJm leased______________________--------=- <br />(Over) <br />I ~I <br />i <br />I~ <br />,~~;~ <br />~~1;1 <br />~ I ~ , <br />I,, <br />i <br />i <br />i <br />i <br />, <br />~ 1~ , <br />,. <br />!~ <br />jj' <br />1, , <br />i <br />r', <br />i. ,, <br />i <br />i' '~.II~ <br />j, <br />i <br />,. <br />,i , <br />I "' <br />f L ~~ <br />.~• <br />~ '~ <br />