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8 eam- <br />shift. <br />shift. <br />shift. <br />shift. <br />;hitt. <br />Ihift. <br />shift. <br />shift. <br />hift. <br />hift. <br />hift. <br />/~ <br />6~~ i <br />6e <br />M(I~NE REPORT 314 <br />Note-Please fill ont this report carefnUy, write ptaitaly and answer aII gneationa folly. Be sore to <br />date the report and alga it~FYIlAO~nt,b-oth sides of the sheet. ~j' <br />-~ '~-T~'~ ~- -- ---------~ Colorado, --fi'~~t~ ---/-~-----~ 19_l <br />BUREAU OF MINES, STATE OF COL. <br />T. R. Henahen, Commissioner oP Mines,// <br />Denver, Colorado. ~) <br />Sit: In accordance with Section 4299eed Statntea, redo, 1908, I enbrpit report as Poll ((y <br />u.com <br />en ooe ~' <br />pu.; atLerwlw <br />i.... a etw <br />u .arm <br />~~ <br />EII out thb <br />ryue• atEmrlM <br />lane It m.nk <br />'Name of Company-The! <br />Inaarpornted in the~S to <br />Principal office ~Cff>>,~~~,~yy <br />Capital stock ___~v_1!, <br />Presideat <br />Secretary <br />Treasurer <br />Manager <br />--- O-"4 <br />_____ Shares, at $__l~' per share. <br />I <br />----- -~ <br />Title oP PartnerahiP-------------------------------------------------------------- <br />Partners' Nantes P. 0. Address <br />-------------------------------------------- --------------------------------- <br />-------------------------------------------- --------------------------------- <br />-------------------------------------------- --------------------------------- <br />._ _. .~ <br />------------------------------------------- ------------------------ ~i <br />~lfannger------------------------------------ --------------------------------- <br />Names of Owners <br />-------------------------------------------- <br />If nell6er ____________________________________________ <br />mmGW ~~pmp~~t <br />lilnout~aW <br />-------------------------------------------- <br />^D.n <br />bianngnr------------------------------° ---- <br />f Stnte names of el~aim~p:_~ <br />y ~----1f------------u------1------ ---------- <br />P. O. Addresses <br />--------------------------------- <br />_________________________________ <br />Unpatented <br /> <br />~!~~rv3' ~t-----------~ ----------- ---------------------------------------------- <br />~h • <br />n _____ <br />_ _ ___ ________ ______________________________________________ <br />,~ . <br />- ------- - ----- <br />----- ---------- <br />. ry ncr~~ ~l ------ ----------------- <br />g patents ~~~_ ~ ___acres; unpatented______ ___aorea. 1 <br />-- _r~== ------- <br />Do yon own or lease these claimet~~rr7_~___________ __ ________ ________ ~` <br />- ------- / f .. <br />If you lease them give name of company or person from whom leaaed_ _Lrl _~1.~ ~~ ~1-~______ <br />---------------------------------------------------------------------------------------------- <br />(Over) <br />~ f <br />~~~~ <br />f, , <br />I:~1 <br />