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If a rampant. <br />ell oat l is <br />apaw: aNatwlw <br />leave it blank <br /> <br />MINE REPORT X22 <br />Note-Please fllI out this report carefu]Iy, wr(te plainly and answer all gnestiona folly. Bo sore to <br />date the report and saga it. Fill~o~ntAb'oth aides of the sheet. //~A <br />`f <br />---•--i--=-=-------------------- Colorado ~1/'i~-""'!'~- 2 19!_!y~ <br />BUREAU OF` EIINES, STATE OF COLORADO. <br />T. R. Iiennhen, Commissioner of illinea, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revise Statutes Colorado 1908 I b ' <br />u . etm <br />or prmenhlp, <br />ml one tw <br />tpaw: athernW <br />lease IL Dlank <br />If neleher <br />wmpanl nw <br />artnenhl <br />SII oat tab <br />,Paw <br />- - ------- - ----- ---- ---- - - ~~`-`e-`~'--=`--- - -- -- - <br />--- - <br />P. 0. Address <br />fit. ~ -----`-~ a / r---- <br />_________________________________ <br />P. 0. Addresses <br />---------------------- <br />-- ~o~ <br />tl t Pnten~ i/ Unpatented <br />/j <br />i 1; <br />i au ml rep9rt as follows: <br />~ -- <br />'Name of Company-The___ _'''~~ /_ _!'~_____________ <br />Incorporated in the State of_"L_°~__~ "~_ '~~n~ ~`-`~ <br />----- -- --- <br />Principal office _~P~ `L ~~' /!1' __--------- --_---- <br />---- - -- <br />Cnpitnl stock ___________________________ hares, at $__- _____ Per share. <br />y Nnmo P. 0. Addresses <br />President ----AIL------------------------------- <br />----------------------------- <br />Secretnry -----~G------------------------- <br />--- ----------------------------- <br />Treneurer ___~~~ __ <br />- ------------------ <br />---- ---- ------~ <br />---O- ~~ <br />lfannger _-! N~___----- ~IGU~-tJ ------ <br />11 ~~~ a 79- v <br />of Partnersltip______~!_~__ ~Y~`i <br />7 Partners' NnJm/cs o //// <br />r ~r <br />'~'~'G.J________________________________ <br />I~TamC3 Of Owners <br />-,.fl-~_ y~.....~...,.--~~ ~ - <br />__ <br />_ Y______ <br />___ <br />___ <br />)Ianngt:r_~~ __ __ ____ ____ <br />State names of claime:~~ <br />--~--~--^_-~- j <br />Total acreage patented___--------------scree; unpatented__^ _______-_- _-----__---acres. <br />~~,~// pp~ I -------------- <br />Do yon own or lease theso clnimei____~Y__E__~t?--------------- --- <br />If you ]ease them give name of company or person from rvllom leased_____________ ~~`=~ ------ <br />rover) <br />