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1/6/2009 11:33:07 AM
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11/18/2007 12:22:03 PM
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LO. <br />Iri7.oe <br />.MINE REPORT 112 <br />Note-Please fl6 out this report carefully, write plainly and answer alI gneadans fully, Be sere to <br />date the report and sign it. Fill out both aides of the sheet. <br />'-"---- ------____, Colorado <br />--------------- ~ -------------------------~ 19--- <br />BUREAU OF bfSNES, STATE OF COLORADO. <br />T. R. IIennhen, Commissioner of bIines, <br />Denver, Co]orado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorn o, 1908, I submit report ae follows: <br />~i <br />Name oP Company-The__~V1 <br />t~~~-------------- --------------------- <br />Incorpornted in the State of__________ _________ _ <br />---------------------------------- <br />Principal office ___________________________ <br />It.coa, Capital stock ___________________________ Shares, nt $ pcr share. <br />el~ t t Name -_-_ <br />Ir.~ a DI•ak P. 0. Addresa® <br />President --------------------------------------- <br />----------------------------- <br />Secretary --------------------------------------- <br />----------------------------- <br />Treaeurer _______ <br />------- ----------------------------- <br />bfanager --------------------------------------- <br />u . erm <br />ar p•rtoenNp. <br />an sat wl. <br />ryae•: orDer.W <br />leas 1t DI•ut <br />It ne116a <br />mmG•a7 oar <br />n•nnenDlpp, <br />all out t:d• <br />•p•d <br />'Title of Pnrtnerahip--------------------------------- ~ <br />Partners' XRmes P. 0. Address <br />-- --------------------------------- <br />l <br />~ 1 i <br />_ __.__ ~. <br />I <br />i ~ <br />Slnnnger------------------------------------ -------------------------------- <br />Names of Owners P. O. Addresses <br />-------- - -------- <br />- --- <br />--- ---- <br />T ---- --- ---- ----- <br />---- ., <br />State names of claims: <br />.,+ Patented Unpntented <br />v ., ~ r <br />---------------- <br />------------------ -------- <br />Total acreage patented~~____~vd-..__a jes; unpatented_~150.~____s~Q-____aerea <br />Do yon own or lease these claimet______dUIYV_~~.A~.91~111~----------------------------------- <br />Il you lease them give name of company or person Prom whom lensed________________________________ <br />---------------------------------------------------------------------------------------------- <br />(Over) <br />I <br />~ .i, <br />I <br />`` ~~ <br />I <br />
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