MINEBK01108

• County: Teller
• Document: Manager
• Suffix: B

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MINE REPORT
Note-Please 8II out ibis report carefully, write plainly and answer all questions folly. Be sere to
F~71 oni both sides
of the sheet.
date the report and sign it
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BLi;E9ti OF DiINES, STATE OF COLOE~DO. /
7, P,. Henahen, Commissioner of `Mines,
Denver, Colorado. >
ir- In accordance with Section 4299, RRVised Statutes, Colorado, 1908, I submit report as follo~cs:
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Incorporated in the State of_______-- -------
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-- Principal office -----~-- - - - ---- - -'- - --=---------
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Caprta] stock _3_-----__- ___P__---Shares, at ~
$_~-GO___ pcr share.

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Name
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President _~t`--- - ---- - -
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~Seeretary _ ~/,~.rti•c~~FVl~~</~------ ------~'------------~~--v--

_,-. ; ": ~ Treasurer

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Dfanuger- - - _
- Nu~ues of Ox•uera
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names vl' claims:
Patented I; n p:d ~• n ted
~r,.,~,~ ucrcu v ~-------- - .acre; uupuU:nted_
g. 1aLeuted___.~~~-
Uo rpu own or lease theae claimsi_--_(~N --'- .
If :",!I .case them give Hume of company ur tierrou r7~~m wb~nn leunl:d_
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