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Form 2, PERSONS, FIRMS AND CORPORATIONS STATISTICS FOR THE Y E A R 1917 Collected by Robt. F. Cole Labor Commissioner for the State of Nevada P E N A L T Y FOE FAILTJBE TO F U E N IS H D E T A IL S A N D STATISTIC S Chapter 203, Statutes o f Nevada, approved March 24, 1915 “ Sec. 11. Said Labor Commissioner shall prepare forms and blanks fo r the purpose o f gathering the information and statistics required by this Act, and may require any person, firm, or corporation to give the information and statistical detail designated in such forms, and any person, firm, or corporation who shall refuse to furnish such detail and statistics in the form required, shall be guilty o f a misdemeanor, and upon conviction thereof may be fined not less than one hundred dollars nor more than five hundred dollars.” IM P O E T A N T INSTEU CTIO NS 1. This form must be properly filled out and returned to the Labor Commissioner o f Nevada on or before .................-S - ...............1918. 2. Each question should be answered fully. I f the answer is “ no” or “ none” such word should be written to properly answer the question and as an indication that such question was not avoided. C E E T IF IC A T IO N OF STATISTIC S This is to certify that I have read the foregoing requirements o f the law and the special instructions con­tained above, and in accordance therewith I have prepared, or caused to be prepared, the following answers supplying the statistical information required, which is true to the best o f my knowledge and belief. Signed at Name. this day of. Title