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1/12/2009 12:20:50 PM
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11/18/2007 12:28:47 PM
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~°` ~ } ~ <br />MINE REPORT ~~ <br />Note-Please fill oat this report carefully, write plainly and answer all gneetions folly. Be sore to <br />date the report and sign it. Fill oat both aides of the sheet. <br />---~~- __, Colorado, _________,~`f '~ __, 19I_!~ <br />-- --- ------- <br />BUREAU OF DIINES, STATE OF LORADO. <br />T. R. Iienahen, Commissioner of alines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, I;evise Statutes, Colorado, 1908, I submit report as follows: <br />Name oP Company-The_______________ <br />Incorporated in the State of_ ~~________________________ <br />Principal oRice ~_~ 8 _--_.o__-- ---~ -_----------------- <br />-------- ------------- <br />u.com Capital stock ______~_,4-z~-sZ~ uy_y____Shnres, nt $____f _°__ per share. <br />ell oat thl. <br />.p.<.; otDenW Nome P. O. Addressee <br />lane it bl.ok <br />President -------------------------------•------- <br />----------------------------- <br />Secretnry ________________ <br />----------------------- ----------------------------- <br />'14~ensurer -------------------------------------- <br />----------------------------- <br />111anager --------------------------------------- ----------------------------- <br />Titlo of Pnrtnerehip_____________ <br />Partners' Names <br />u .arm <br />ar pumenDlp <br />Ell oat t64 ___________-.________________________________ <br />ep.n; atberwW <br />Inre It D4ok <br />Slnnnger_______ <br />Names of Owners <br />___ ____________ ____ _ __ ____ ______ <br />Ir neither <br />eompeor nor <br />nn` oue~ei~: <br />-------------------------------------------- <br />epen <br />~Dinnnger_______ <br />Stntc names of claims: <br />Patented <br />P. 0. Address <br />--------------------------------- <br />--------------------------------- <br />_________________________________ <br />_________________________________ <br />P. 0. Addresses <br />------------------------ <br />Unpntented <br />-------------------------------------------- ---------------------------------------------- <br />---------------------------------------------- ---------------------------------------------- <br />--------------------------------------------- ---------------------------------------------- <br />---------------------------------------------- ---------------------------------------------- <br />Totnl acrengo patented____________________-__--acres; unpatented___________________--------acres <br />Do you.own or lease these claimaf--------------------------------------------------------------- <br />IP you lease them give name of company or person Yrom whom leased-------------------------------- <br />---------------------------------------------------------------------------------------------- <br />(Over) <br />
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