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]