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~~o~ri i,~ , ~~ l' <br />3 ;' <br />MINE REI'ORT`~I ~ ~ ~:~ ; ~, I <br />Note-Please fill oat this report carefnlly, write plainly and answer all questions fully, Be sure to <br />date the report and sign it. Fill oat both sides of the sheet. <br />------ ----------------, Colorado ~~ __'~_~_!__, 19~c3 <br />BliRb:9U OF' i1fINES, STATE OF OLORADO. <br />T. R. liennhen, Commissioner of \[ines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report ns follo~ve: <br />If • CnmpaoY, <br />eu apt t la <br />tpace• othenrW <br />(rare It blurt <br />If . arm <br />or Dortnrnhlp, <br />III oat thin <br />rpam; othcrwiw <br />4n'r IL blank <br />If nrll h<r <br />company not <br />ysrtn.nhl pp, <br />fll out lhla <br />.pan <br />Name of Company-The---------------------------------------------------------- <br />Incorpornted in the State of__________________..__-.______.._________________________ <br />Principal oflice -----------------------------------------------------------------.. <br />Capital stock _________________________._ Stlares, at ~____________ pcr share. <br />Name P. 0. Addresses <br />President --------------------------------------- <br />Secretnry --------------------------------------- <br />Treneurer -------------------------------------- <br />1lnnnger --------------------------------------- <br />Title of Partnership---------- --------------------------------------------------- <br />Partners' \'nmes P. 0. Address <br />-------------------------------------------- --------------------------------- <br />1inmLger------------------------------------ --------------------------------- <br />Names of O~vnere P. O. Addressca <br />-- rr --- <br />_____ ___________ ________ ___________ __ __ ___, .. ~ /moo' <br />_Q__p_y_/~/_~___~_fy//J ~(/~~// ___/__v_ _W_ <br />titatc names of claims: 1/ <br />Patented Unputented <br />------ --------------------- <br />i <br />- ---------------------------------------------- <br />~~A~^-~~---- <br />~!2J---1ZZ Z'--------------- <br />---- ----------------------------------------- <br />Total acreage patented__-st`-f~-~------- ---arses; unputented---------------------------acres. <br />lIo You own or lease these claimst______Lz` -------------"--____-' <br />!f you ease the~~ ~ic;nnme company or perso`from wl lensed_________________ __ --- <br />C.C~iGBC/ ~ -------- <br />( ver) <br /> <br />i~l <br />~~~ <br />II <br />e <br />'I <br />`, <br />