Chapter XVII: Appendix: #8

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No. 114. ADDITIONAL AND AMENDED LOCATION CERTIFICATE.
--Bradford-Robinson Ptg. Co., Mfrs. Robinson’s Legal Blanks, 1824–46 Stout
St., Denver, Colorado

STATE OF COLORADO, }
}
} SS. KNOW ALL MEN BY THESE PRESENTS,
County of _______________}

That ______________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

the undersigned, ha___ this _____________ day of ___________________, 19___

amended, located and claimed and by these presents do _____ amend, locate

and claim, by right of the original discovery and this Additional and

Amended Location Certificate, in compliance with the Mining Acts of

Congress, approved May 10, 1872, and all subsequent acts, and with Sections

169 and 182, Chapter 110, 1935 Colorado Statutes Annotated, and with local

customs, laws and regulations _____________________________________________

____________________________________ linear feet and horizontal measurement

on the ________________________________________________________ lode, vein,

ledge or deposit, along the vein thereof, with all its dips, angles and

variations, as allowed by law, together with ______________________________

feet on the __________________________ side, and __________________________

feet on the __________________________ side of the middle of said vein at

the surface, so far as can be determined from present developments, and all

veins, lodes, ledges or deposits and surface ground within the lines of

said claim __________________________ feet running ________________________

from center of discovery ________________ and ________________ feet running

__________________________ from center of discovery _______________________

said discovery _____________________________ being situated upon said lode,

vein, ledge or deposit, and within, the lines of said claim, in ___________

____________Mining District, County of _______________________ and State of

Colorado, described by metes and bounds as follows, to-wit:

Beginning in Corner No. 1

This being the same lode originally located on the _________________ day of

______________________ 19____, and recorded on the _________________ day of

______________________ 19____, in Book ________ Page ________ in the office

of the Recorder of ____________________ County. This further Additional and

Amended Certificate of Location is made without waiver of any previously

acquired rights, but for the purpose of correcting any errors in the

original location, description or record, and of taking in and acquiring

all forfeited or abandoned overlapping ground, and of taking in any part of

any overlapping claim which has been abandoned, and of securing all the

benefits of said Sections 169 and 182, Chapter 110, 1935 Colorado Statutes

Annotated.

Said lode was discovered the ________ | ___________________INTEREST. [SEAL]
|
day of _________________ A. D. 19____ | ___________________INTEREST. [SEAL]
|
ATTEST: | ___________________INTEREST. [SEAL]
|
_____________________________________ | ___________________INTEREST. [SEAL]
|
Date of Additional and Amended Cer- | ___________________INTEREST. [SEAL]
|
tificate _______________ A. D. 19____ | ___________________INTEREST. [SEAL]