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,s 4 <br />~~ ,- <br />MINE REPORT ~~'~ ~~ , .. <br />,~; ~ <br />_~°• . <br />Note-P;^ase fill out this report carefully, write plainly and answer all questions fully. Be sire to <br />date the repot aad sign it. Ft11 out both sides of the sheet. <br />-------Czi~ID1Q_&r~ek_____--. Colorado, --IIose~bcr.12,. Is13. <br />BLT.I.9ti Os' 3tI\ES, STATE OF COLORADO. _ <br />T. P. IIeai:hen, Commissioner of 3finea, <br />Dearer, Colorado. <br />Sir: Ic nccordance with Section 4299, Revised Statutes, Colorado, 1905, 1 submit re),nrt ns follo~r,; <br />'\nme of Company-The_I'hASWf30~Ste_S,O~d_lliIIiIlg_ ComPeIIy. _ <br />Incorporated in the State of____ ~y_QID~.Itg, ___ __ <br />_.. .- <br />- --- - <br />Principal office __rripple__Crstt>:,__C910xad0,_ _ <br />One -C>?nt - _ _ _ -. . <br />Capital stoek __1,5.QS2.OS20____________6hares, at~j(_____-. ner share. <br />c . comp+n). <br />°"'"° Dame I'. 0..iduresses <br />,fit[: nlL.r~ue <br />MR r. Bunk ~ . <br />'President ___.L.~_C:.._Cezltnn._______ -_____ Crinnle_Creek, Colo._ <br />secretary }-----____-- _ <br />H. Z. Shepherd Cri le Creel: Colo, <br />Treasurer)- ----------------------------- Pp <br />- -- <br />xanager ____Z.._~.__Carltoa________________ Cripple Cree)!, Colo.. <br />'Title of Partnership-----------------_ __- --- <br />Partncr~' \amrs <br />c~e~ <br />ar WrtnmAlp, <br />::: or. IDi. ._._______________ <br />rx.. o:u..ww. <br />'m- t: L!u~.i <br />Jianagl+r_____._____ .. ________________-- <br />:~rnmes of Ox•nere <br />r uenLV .. ____________________________ <br />W^.umulp, <br />•JrR <br />liunager __ .. - __ _ . <br />~'e;,~ lu:n,,., ,,f cluims: <br />Patented <br />?'haffi8C1Et~-------------- ------- -- <br />P. 0.:1:', d ress <br />1'. t). .~,alrr5ti:'ti <br />1'u p:, t,•n t~~d <br />j7Ql4o.. <br />'!ot::! ... IfOIIe. <br />•~ rP":)'= I~iltentt:d_____t14>Z~~~___ __arr1;K~ UII(~a tCn~ed_ <br />U09ou on~a or lease these clnimet__________.Or7S1.-- ~-~ ~ - <br />11 y„u 1,;;:nrv tLem gi~•e nurse of company or person from x!nvn Icusud- <br />------------ - <br />:ores. <br /> <br />,I ~~ <br />~ ~ i <br />i <br />