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,..-,1w~ ~ 1.:., <br />~..i0 <br />MINE REPORT <br />Note-Please flll oat this report carefully, write plainly and answer all questions fully. Be sure to <br />dsie the report and alga it. Fill oat both sides of the sheet. ~j <br />---•-----~.~-C~[?-------------~ Colorado, -~~~---LI__r=~_. 19.3 <br />6UItI:AU OF i\IINES, STATE OF COLORADO. <br />T. R. Ilenahen, Commissioner of 1lfines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report ns follo~va: <br /> Name of Company-The------------------------ ---------------------------------- <br /> Incorpornted in the Stntc of___________________ __--------------------------------- <br /> Principnl office -------------------------- ---- ----------------------------------~ <br /> Capital stack _______________________-___Shares, nt $____________ per ehnre. <br />p <br />' °ain '°'' <br />ml not thl. <br />Name P. O. Addresses <br />,Deena oth°rrrW <br />Icerr Il bleak <br />President ------ ----------------------------- <br />--- ----------------------------- <br /> Secretnry ------------------------------------ --- ----------------------------- <br /> Trenaurer ----------------------------------- --- ----------------------------- <br /> linnnger ------------------------------------ <br />` I <br />~~ ~ --- ------------/x/---------- <br />~ r V <br />~~"`~~ <br />~ <br /> ~ ~'_~ <br />Title of Pnrtnershi <br />p---- - - <br />----------- <br />~ <br />-------------- ----- <br /> Pnttners' \'nlncs <br /> <br />t- . <br />, P. 0. Address <br /> / - - <br /> /~ ~ ~ <br />- 7 <br />- <br />~ <br />IA e arm <br />All not tale ~ j _ . <br />~ <br />______._ __-.~..oGw___ ..________________________________ <br />eperr: othrrwbn <br />Our It Llmk <br /> lllnmt cr------f ~ ~ <br />g , ---~~~ ------- -- ------ /-L-~-------------- <br /> ATnmes of Otanere P. 0. Addresses <br /> <br /> <br />If nrlth<r <br /> <br />_____________________________ <br />---- --- - <br />------ <br />_.-- <br />----- <br />rmm~enr nnr <br />oertnrnni ~ <br />all out t'u <br /> <br /> <br />-------------------- <br />"--------------------' <br />------------- <br /> <br /> <br />------------------- <br />•pe<n ______..___. <br />lianngur-------------------------------~---- <br />Shoe names of claims: <br />ed n2pntented <br />~~.~ ~ P~ atent~ <br />the ` (/_ <br />'- - cL---~=t yC1=~~'~------------------ -----------~ - - -- i -------------- <br />GI Cly , o ~ ------- - - <br />I // <br />--- I- ~ <br />-------- ----------------------------------- ---/i <br />--- --- <br />-- ----------------------- <br />--- ------------------ -------------------------------1------------- <br />---------------------------- <br />d~ _~crea; unpntcnted_____--- ? - ----~ - --acres. <br />'fotnl ncrenge pntented______~O______----- <br />ny; -------- <br />----------------------- <br />Do you own or lease these claims4______-- -- -~~ ----" <br />illem give name of co or person from~i~omlleased-------------------------- <br />~ -- If you lease, ~~ <br />~`~ / , <br />--- <br />--- -- <br />----- ----- --. (ever) <br />'(.~R''> <br />