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^ <br />I <br />', <br />:; <br />MINE REPORT <br />Note-Please Sll oat this report casefnlly, write plainly and answer all questions folly, Be sere to <br />date the report and sign it. Fill oat both aides of the sheet. ~ ^ / <br />---._ ~i~t_rC3C~~_, Colorado, -_l.~!~'.>z!~__-%~-----, 19~~ <br />BUREAU OF DANES, STATE OF COLORADO. <br />T. R. Henahen, Commissioner of Dlines, <br />Denver, Colorado. <br />Slr: la accordance with SeuL:oa 4299, Revised S/tlat~utes, Colorado,/19n3, I subm report a's follows: <br />ATame of Company-The_ _ `~!'r-'r-a'~ ~T ~ _"~ <br />Incorporated in the State of______________________- _~ ~________________________ <br />Principal office -- --------------------~-~ --- -- -------------------------- <br />Capita] stock ___________________________. me t g________.._-._ per share. <br />I7 a Compavr. <br />an ant t 1. j Name ~~ .Addresses <br />I°ite 'li o .a~a <br />President -- -------- ---- ---- ---- • --------------T1~ -C ~.~--- <br />Secretnry - ~~-6------- ---~-- -- --------~~f91!~~-- ------ <br />'~n,- I I~ <br />~Trensurer - -- - ~~ --------~ --- ------------- <br />i <br />~`3lannger ------ ---- - -------- ---- <br />rTiUe of Par rehi __~!0''___~-O-.'/o. ---_ -- - ----- ---------------------- <br />I Partu~•r:;' \:unyr~i -- P. O. Address <br /> <br />s • Erm <br />or Inrlnmhtp, <br />1111 out thla <br />.poor; otherwpa <br />Irov. It blank <br />fo nrither <br />ngnnr nor <br />purtuer.hlpp, <br />all uul tide <br />gwce <br />DlLLnllgl'1'______ ______ ___ ___-___.._._____.. <br />r N:.mea of Owners <br />i <br />I'. O. Addreeacs <br />_ ~~ Alunugel _ - - <br />__ state muuca of claims: <br />Patented Unputcnted <br />in the <br />------- ~. I ------- -------------- <br />'1'utul ucreure lutcutcd__--._-----..._-_----_---acres; un>utented__ ._---._ ..acres. <br />mpany. - _ - _ -- <br />f)o you owp or leaso these claima4____-__- - --'_- " <br />!_ ~__ 1f you lease them give name oY company or person Yrmu whom leuaed__..__ - --- - ---- <br />- -- <br />_____ _ (Over) <br /> <br />4ll <br />`~ <br />I~` <br />i <br />fi I <br />,~I <br />~1 <br />