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1 - ~~~~~~ <br />~'~" MINE REPORT as <br />Note-Please fill out this report carefully, write plainly and answer all questions folly. Be sure to <br />date the report and sign it. Fill out both sides of the sheet. <br />. To ~~Jr <br />---------!/~fi--------..cai aerie, ---~~ - /~ Is~!~ <br />BUREAU OF ALINES, STATE OF COLORADO. <br />T. R. Iienahen, Commissioner of Alines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, ]~UQ, I submit report as follows: <br />Nome oP Company-The___~ _tt-~.~~.______~/_J~_~______________ <br />Incorporated in the Stnto of______________________________________________________ <br />Principal office --------------------------------------•--v lE-~--•~.-.--~-)^~ -i--.. <br />Cnpitnl stack ___________________________ Shares nt $ psi' shore <br />If a Compaq. <br />fill oat t b <br />Ivor: othailr <br />In~r It blank <br />If a arm <br />rr partamklp <br />ail out lhb <br />leirre it Dlanr kI~ <br />Nome P. 0. Addressee <br />President ----------------------------------- <br />Secretary --------------------------------------- <br />----------------------------- <br />Trenaurer -------------------------------------- <br />----------------------------- <br />Afanager --------------------------------------- <br />----------------------------- <br />Title of Pnrtnerflhip-------------------------- <br />Partnors' \nmes <br />-------------------------------------------- <br />____________________________________________ <br />Afnnnger------------------------------------ <br />--------------------------------- <br />P. 0. Address. <br />--------------------------------- <br />--------------------------------- <br />_________________________________ <br />_________________________________ <br />--------------------------------- <br />~ Names of Owners P. 0. Addressee <br />---~JC1=~_'il- ~Za~GiF2`-cam`-''----- -,---- ------- <br />- - ~ --- <br />11/_ - ------------ -/ _ <br />If nclther ------ `/ f'r/-'ice-,---~~----- ---- -- --y~~-7----~~IItN -- <br />rompanr oor <br />prrtnenhlPP. _ <br />__-_ <br />all out t4la ______________~--_'-__--____ __---~-____ t-'-'-_-'__--__-___--_--__-__'__-'_ <br />rPaar <br />------------- ----- <br />1 <br />Jinnager--- -~i`'°---- - --h/~-rTS~r~_6""`„ti--------------------------- <br />State names of claims: <br />Patented Unpatenteo <br />---------------------------------------------- ------------------------------------------ <br />---------------------------------------------- -------------------------------------- <br />Total ncreago pntented__-fQ -~-~-acres; unpntented---------------------------acres. <br />Do yon owe or leaso these claimst--------------------------------------------'-"'--"-"--_-----~ <br />If you lease them give name of company or person from whom lensed-------------------------------- <br />---------------------------------------------------------------------------------- <br />(Over) <br />,i v^ <br />