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~~ <br />./ <br />1 ~ ,,., <br />MINE REPORT <br />Note-Please 8ll oat this report carefully, write plain]y and answer all questions fully. Bo sure to <br />date the report and sign it. Fill oat both sides of the sheet. <br />. _ _--_-. Colorado , y _, 13_-- <br />(317:F.Ali OF' i111NES, STATE OF CO7.ORADO. <br />'f. It. Iienahen, Commissioner of Dlines, r <br />Denver, Colorado. <br />bir: In accordance with Section 4233, Revised Statutes, Colorado, ]308, I submit report na follows: <br />r. <br />Name of Company-TLe-- ~..-~- - -- - - - -------- <br />Incorporated in the~ysS,~{ta~~t~~e~~of//_~~_--__ ____ry,~ ~-~~Q----------------.------ ------- <br />Principal o1Bc`e`,,~~_--_ ~_!L!FF<.Y1.t~----!-`=~!~_~~ -- ----.._..__ -_ .-----.___-_ <br />Capital etock?!~~~~~p_._ .. ._Shuree, at $_.~r~^_-_ per share. <br />EII`eu: i~°r' J ~ Name P. O. Addresses <br />iwce; utlwtW <br />President --- - '. ~~-- -y ---• - - - _ -- - ,O°7` --1~~--~~~~LU ~rLQi <br />/~ '_ / -- _ <br />Secretary _ ~0_GLc_i~~~ _- - -- ~~/L~-/{Qiy~-~y'i' ~i_~ " s' <br />1 iTreasurer _'S7_:JY~LLs-~--~'-!'-~-'~~"f- •'-des. - _ !~`!7/e?//~ ~~~,lot~" <br />Alannger __'-' -- - -- - _ _`~' <br />r'1'itle of Purtnerehip_____ --- __.. ____-__ .. _---- -- - <br />Partmvs' 1:unes 1'. 0. Address <br />r.m~~ _ - - <br />rWa.W <br />u' out tL6 Y' J __. - _ - <br />.yar: otLarrLs <br />i .- <br />i <br />~~ Dlunuger _ - <br />r Numes of Owucrs J'. !). Addresses <br />I <br />,,,I~.u> ri`ver I <br />~~ ._.. <br />- _ <br />41unager..- - <br />':~1~ Humes o1' claims: <br />Pulsated ~ IAlpulcutca <br />~~ ~~ <br />- --- -------------- - <br />:Ll'1'etl <br />7~.1 a1 uercuge pnU:uWd---...~~~_-.._ .---acres; uuputeuted-. ~~ <br />_Company. >>o you own or Jesse those clnimrT_____!!"K!u~ <br />~)_i /~~' 1f you louse them give Howe of cowpony or person frow whom lcused_- - - <br />--- - <br />-- - - <br />~ -- (Over) <br />~~~ <br /> <br />