HomeMy WebLinkAbout904159AFFIDAVIT OF ANNUAL ASSESSMENT LABOR
LODE MINING CLAIM
STATE OF WYOMING :
: SS.
COUNTY OF LINCOLN :
RECEIVED
LINCOLN COUNTY CLERK
9 0 ~, I 5 ¢ 0,'..~ net 28 F ] 2:30
The undersigned, being duly sworn, states:
1. At least $ 100.00 worth of labor or improvements was performed or
made during the annual assessment year beginning at noon on September 1,
20 03 and ending at noon on September 1, 20 04 upon or for the benefit of
the follOWing listed lode mining claim:
~ :in
I~,~ c~ ~laim hn~k/~ ~s) S~ bb(s).
Peacock Claim #1 562/557 WMC260692
14/194
2. The labor or improvements consisted of: Mining, ~hich oEr~i.~rcd of ze-
m~cing th~ va],~ble ~1.~, e/thor fro~ th9 ledge itself or fall6n b3 the kese, or that had
f~ll _~3 or ~ ~ the ~ strea~ l~. Purciv%~i~ ~ insY~llln~ treabs]l fcur ~
~,~.~_.~. 0571' /:. t 0t, 5,~
and was done at the following location: Peacock Cia±m #1
3. The person(s) who performed the labor or zmprovements are iden-
tified as follows: Heather Hulse, Mike Hulse, Jesse Allred, C. Mark Allred,
Darlene A. Allred, Jacob Allred, and Doreen Allred. ~
R~ .~' ~ k .~PR PA(,~ ., _
4. Said labor or improvements were made at the request and for the
benefit of C. Mark Allred owner of Peacock #1 Claim.
Signature of Affiant
County of ~1.1~,.'~ State of ((
Lincoln ~ VYyo.miflg ((
My commission expires
NOTARY PUBLIC!