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m- <br />1VIINE REPORT i~ <br />Note-Please fill out this report carefully, write pts,inly and answer all questions fully, Be sere to <br />date the report and sign it. Fill out both sides of the sheet. <br />------911ue___1111Y~----____-, Colorado, -----y+l=b.l,_1fl1~----, 19--- <br />BURF.AU OF i1fINLS, STATIi OF COLORADO. <br />__ T. R. Ilenahen, Commissioner of .lfincs, <br />Deaver, Colorado. <br />Sir: In accordance with Seetion 4299, Revised Statutes, Colorado, 1908, I submit report ne follows: <br />If . Comppwr, <br />ell oo[ thb <br />.D.ce• otherwlw <br />levn It bl.nk <br />If . erm <br />ar D.r[ornhlp, <br />OII out lh4 <br />tD.nt: otherd.e <br />Irne It blink <br />-Name of Company-The__.BBDgiCk_Pzold_ttsin°_s:Ompany-------------------- <br />Incorpornted in the State of______IL2Yl__t7yTe,ry <br />----- <br />Principal o0ice _____ <br />Qti°MtYH ; -CZ3113:------------- -------------- <br />Capital atocl: __2c~S1Qp.~OSZO~_QO-_-_____Shnres, at ~_~~_OSL_____ <br />Name Per ehnre. <br />P. 0. Addresses <br />President ----AI1dPe#-fisd9~r-$P1d~epOPt- CCIli•1-------------------------- <br />Secretary E. V!. AAA91Ck " • <br />-------------------------------- ----------------------------- <br />'Prcasurer ________________________ <br />-------------- <br />----------------------------- <br />ltnnngcr __ R__W~_~laCK°tt, y11Ver C111'i, Colo. <br />Title of Partnership______________________ <br />---------------------- <br />Partners' Names -------------- P. 0. Address <br />- -------------------------------------- --------------------------------- <br />___________________ <br />lfannger-------------------------'-------= ' <br />- --------------------------------- <br />ATnmes of Owners <br />If nellher <br />rnmpmr nnr <br />prttnenhlp, <br />ea un[ tbl. <br />.pa <br /> <br />[anngcr-------------------------------~---- <br />Stntc nnntes of claims: <br />P. 0. Addresses <br />--------------------------------- <br />-------------------------------- <br />Patented ~Un atented <br />P <br />v LookdCt~ ~ , NesdPul <br />--~isme3sa-~='--------------------------- ---------------------------------------------- <br />-- /W1 !_lien _/_---- --------------------------------------------- <br />----------- ------ <br />----- <br />d Hstty aresn <br />- i-gl'8I11C i.'~----------------------------- - ----------------------------------------- ---- <br />-- /sprinv-~----------------------------- <br />t~n -ci,eQ,o,,.rgia ~ <br />Ta V,/a~i~e~~t~lte'~ $fT ""'--------acres; unpntented---------------------------acres. <br />Do 9~~~Ii~se these elaimet--------------------------------------------------------------- <br />If you lease them give name of company or person from wham lcased________________________________ <br />------------------------ <br />(Over) <br />