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om- <br />~_ <br />hilt. <br />hift. <br />hift. <br />hift. <br />hilt. <br />Rift. <br />hift. <br />hift. <br />hift. <br />shift. <br />Ihift. <br />n the <br />PaR9• <br />mot/ <br />~ ~ ~~~~~-~.,--~1,., ,/~~... ~,- ~ ~ <br />~~~~._„ <br />\~~ ~ ~ ~ ~ MINE REPORT s <br />Note-Please fill oat this report carefully, write plainly and answer all gnestlons folly. Be sere to <br />v~ Ada the report and sign it. Fill oat both sides of the sheet. <br />~ ~~ ---•-----------------------------~ Colorado, -------------------------,19--- <br />\BURF.AU OF 11fINJ;S, STAT1; OF COLORADO. <br />`~ ~ T. R. Hennhen, Commiaeioncr of Mines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follo~ve: <br />Nome of Company-The---- ------------------------------------- <br />i <br />~ Tncorporated in the State of________._.-__..___-.____,___________________-_ <br />------------ <br />Principal office -------------------------------------- --------------------------•• <br />uacom Capita] etoek ___________________________ Shares, nt ~____________ Per share. <br />ell one t~ Name <br />lew:e ie bl.`tia'~ P• O. Addresses <br />President -------------------------------- <br />------- ----------------------------- <br />Secretary --------------------------------------- <br />-------- <br />Trensurer ------------------------------ <br />~------ <br />D[annger --------------------------------------- <br />Pitle of Partnerehip_,~~~-s-y„r __ t <br />/J,/ Par/t'n~ers' /Names <br />_0_~4.~- - - - ~~- ~------------- <br />u . etm <br />or Dartnen6lp, <br />ell oat thla ------------~------------------------------- <br />rpace; otnetwlas <br />leave It blank <br />______________ _ ____-r.-__ _ _ <br />__ <br />_____ <br />,lSTnnngcr_ _--- a _-- -____-- E <br />~ Nnmea of Owners <br />If neaher __________________________________ <br />__________ <br />nom Pan) nor <br />partnenhlP, <br />II1l sot tWi ____________________________________________ <br />apace <br />[onager------------------------------------ <br />State names of claims: <br />Patented <br />/~ P. 0. Address ~/~~,~ <br />__ _ _________~`_ __~_ /~nJ`. <br />Q f~ <br />- --- J- <br />P. O. Addressee <br />--------------------------------- <br />_________________________________ <br />Unpatented <br />----------------------- <br />---------------------------------------------- --------------------- - ------------------- <br />Total acreage patented~iis.,r~~~^/~-___=-_acres; unpatented____ ~t~zs/_fl_c______acres. <br />Do you own or leaso these claimat__~.C'!~-s~~_r--------------------------------------------- <br />If you lease them give name of company or person from whom lenaed________________________________ <br />(Over) <br /> <br />~.: <br />