CLASS 1 BALLOTS

Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 1 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
# The undersigned Claimant, holder of a Class 1 Empire Secured Claim in the amount of
4>S5) 1/ l . S (P as of the Petition Date:
Check Only One
THE PLAN [ ] REJECTS THE PLAN
Dated: !.) 3 /2-D 1:3
8/U"rtT C. Up1'>.J
Signat
By: (!o,
,
Name of Claimant (if corporation):
DVtJltM Ie. &e.t.6'i 'Sell-VIces. LLC

Address:

LA 161'1
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 2 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
IJ a 7 The Claimant, holder of a Class 1 Empire Secured Claim in the amount of
f 1 3 1;), ," - as ofthe Petition Date:
I
Check Only One
MA-CCEPTS THE PLAN ] REJECTS THE PLAN
Dated:
By: __ ____________________ __
Name of Claimant (if corporation):
(; b,. r;;"q rjy rv:c. I'J .. 1:.- c...
r "'"
Address: S 3'1 J. Ht...I y 31)
I
C, < L- 70360
I
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 3 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 1 Empire Secured Claim in the amount of
$170,569.00 as ofthe Petition Date:
[x] ACCEPTS THE PLAN
Dated: OS/22/13
Check Only One
[ ] REJECTS THE PLAN
Print or type name: Raymond A. Beyt
Signature: ~
,
By: ___________ A_g_e_nt __ an __ d_A_t_t_o_rn_e_y_-_in_-_F_a_ct
Name of Claimant (if corporation):
Stokes & Spiehler Offshore, Inc.
Address: Post Office Box 52157
Lafayette, Louisiana 70505
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 4 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 1 Empire Secured Claim in the amount of
_________ as of the Petition Date:
00 ACCEPTS THE PLAN
Dated: &./ b --/3
Check Only One
] REJECTS THE PLAN
Print or type name: L-e8LluJL"
Signature:
By: MOo. "'- r; a.. eo L e. \3 I ct '" C---
Name of Claimant (if corporation):
WtJ/U-<Otl/( f3pe(ldl...rl :S
Address: / 13 Pr!('(}tEU!f) r!<vJ'/
I
/3/CtJt!5SI1I2P J L/J. 7051%
,
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 5 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 1 Empire Secured Claim in the amount of
$1,245,589.90 as of the Petition Date:
[ ~ C E P T S THE PLAN
Check Only One
] REJECTS THE PLAN
Name of Claimant (if corporation):
Precision Drilling Co., LP
Address: 10370 Richmond Ave., Ste. 800
Houston, TX 77042-4136
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 6 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 1 Empire Secured Claim in the amount of
$84,.498.40 as of the Petition Date:
Check Only One
( ] REJECTS THE PLAN
t:/sj; 3
I I
Dated:

Signature:
By: Earl Land
Name of Claimant (if corporation):
" Inc.
Address: c/o Jacque B. Puc-heu,. Jr ..
P.O. Box ll09
Eunice" LA 70535
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims BaUoting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 20l3.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 7 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF TillS THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 1 Empire Secured Claim in the amount of
$191,622.32 as of the Petition Date:
Check Only One
[J ACCEPTS THE PLAN ] REJECTS THE PLAN
Dated: Print or type::?: LLC
Signature: .. '\ ,-
By: Brian J. Tanner
Name of Claimant (if corporation):
Address: c/o Jacque B. Pucheu, Jr.
P.O. Box 1109
Eunice, LA 70535
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 8 of 40
CLASS 2 BALLOTS
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 9 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTtON OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 2 RLI Insurance Claim in the principal
amount of as of the Petition Date:

Dated: & Ir)/; ;5
--f-j -Ie':-'-'----
Check Only One
1 REJECTS THE PLAN
...-:-: t' /
Print or type name: _1-1,-"1 ;1'\-,-' -fh-!::lJ-'-y=k::::::-____ _
A l
Signature: Lj0vk
By: frffoy(\ f71 eLI-
Name of (if corporation):
RLI Insurance Company
Address: c/o Timothy A. York, Esq.
2001 Bryan Street, Suite 1800
Dallas, Texas
BALLOT MUST BE MAILED. OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 10 of 40
CLASS 3 BALLOTS
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 11 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 802, 1 /
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
THE PLAN
.r /"<'1 ?...
Dated: 5 - ? :/
Check Only One
] REJECTS THE PLAN
Print or type name: i!:4.'Z:-I?9/"f
Signature: /4
By: VIce -' PUS! J) ;1(/'1
Name of Claimant (if corporation):
flrfe/Of ;;eev IrJ 5 &121
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 12 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ ____ _
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
[v( ACCEPTS THE PLAN
Dated: 5\1(.-1 '5
Check Only One
] REJECTS THE PLAN
Print or type name:

By: ____________________________ ___
NaIJle

BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON,ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 13 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ '0 ji...rl. DO 0:-
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
Check Only One
[ THE PLAN ] REJECTS THE PLAN
Dated: 5' I ,"S \ Dn
i t
Print or type name: Dt.iUjAJV\''''' :::.s
\
Signature: MA.N./ t'\iGlI-1-. G: r..:>eL'l'1 Sci Lu::...
By: 12
Name of Claimant (if corporation):
..'\ tMshA LLc'
Address: t l t:.l /l.\..foA.. 200
btl., \ Er..If'-J<>'
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON,ARATA,MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 14 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW. CD
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ \
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
[ v( ACCEPTS THE PLAN
(;;
Check Only One
] REJECTS THE PLAN
. Hugh e..Ir.
Pnnt or type name: _____ --:-___ _
Signature:
By: Hygh e' .. "iIAllr'.
Name of Claimant (if corporation):
Evans Rentals, Ino.
Address: __ ---.--::-r.:P.=.O=. B=o-,x,....8.-03..,..9 ..... 7"'ft11r-----
lafayette, lA 70598
(337) 837.1727
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 15 of 40
ACCEPTANCE OR RE.IECTION OF THE P'LAN
I)LEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUT\.QN OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant. holder of a Cluss 3 Cluim in the unpaid amount of S 1.832.087.83
(For purposes or this Ballot. it is 110t necessary and you should not adjust the principal amount
lor any accrued or un-matured interest):
I x I ACCEPTS PLAN
Dated: Mav .2013
Cited" Onl\' One
I THE PLAN

SiUllillllJ'e:
13;: Michael F.
Name ofCluimnnl (if corporation):
Iidis Oil & Gas Company. L.L.C.
Address: 228 St. Charles Ave .. Suile 912
New Orleans. LA 70) 30
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDO]\;, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Chdms Ballofillg
Place SL. Charles
20) St. Charles Avenlle, Suite 4000
New Orleans, LA 70 I 70-tlOOO
SO THAT IT IS RECEIVED NO LATER THAN: Junc 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 16 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF TIDS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 37(",2 gt, . ~
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
h(1 ACCEPTS THE PLAN
Dated: 5/31/13
Check Only One
] REJECTS THE PLAN
Print or type r;.ULLI AtJ #. A,v beL';
Signature: ~ at
By: lie/me( Diree-k'c>,vd -:Dtl.,tL-,,,,; I If\lC .
Name of Claimant (if corporation):
t\aMGft. 1)C(CliilrJcJ. fu,C,\.I"' :C"''''
Address: 9. > ~ V ) C (.,70
tM.th.lv. . UJ. (oOS rf
J
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place st. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 17 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE B j
IN THE SIGNATORY INFORMATION REQUIRED BELOW. d1 t2tJ: 700 ,
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
[ THE PLAN
Dated: j> :l/ ;Je!;3
Check Only One
[ ] REJECTS THE PLAN
S D
Print or type j!!)"tt
SIgnature: _t
By: (11jC 111J-l!2- 62v IC-
Name of Claimant (if corparation):
,5m DC: II! 'f,:/lnJvJ!, drp
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON,ARATA,MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 18 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder ofa Class 3 Claim in the unpaid amount of$ [Kg I 05ol1j
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
[ C C E P T S THE PLAN
Check Only One
] REJECTS THE PLAN
Name of Claimant (if corporation):
i2oto. crc",.(+ ktA-SI '1 Co; Uc--
Address: 430 ;J. eolt<.. eJ..
SIOU.S$a..&., LA 705/8"
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON,ARATA,MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place st. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 19 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of
(For purposes of this Ballot, it is not necessary and you should not adjust the pri cipal amount
for any accrued or un-matured interest):
Check Only One
[vf ACCEPTS THE PLAN [ ] REJECTS THE PLAN
Signature:
By: ________ ________________ __
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 20 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ ____ _
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
Check Only One
lIJ ACCEPTS THE PLAN [ ] REJECTS THE PLAN
Nt t\ >' Gr /l) G"E:" W V\ W1 u '- c.. A.N'
Dated: (p,p - .3 Print or type name: _____ ----,-___ _

\
Name of Claimant (if corporation):
Address: _____________ _
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 21 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 40 i 0 tJ 0 ~ to
.
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
LX1 ACCEPTS THE PLAN
Dated: ~ / 6 ~ tJ/..3
,
Check Only One
] REJECTS THE PLAN
Print or type name: !&/;//l M. GrJlyetU7
Signature: ./iJJU,71t. ~
By: /!R6ti1t.!&t!eMl . ~ . s d
Name of Claimant (if corporation):
PrpducJr'an Services Nefwtftl<- IA.'S, :rite.
Address: IY()O Kat'! Fw,v) Sf< /50
H()tI.5frJn I 7X. 21094
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 22 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
.,claimant, holder of a Class L Claim in the unpaid amount of
$ rr!2 (F or purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
[vf ACCEPTS THE PLAN
Dated:
Check Only One
] REJECTS THE PLAN
Print or type n
Signature: -F----lI"-----.L-
Title (if corporation): '---'---'-:..JCJ'---'-=-=---+-----==--'--.J:--_=_
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON,ARATA,MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 23 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 1:l s: 00 fUL
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
Check Only One
[v{'ACCEPTS THE PLAN ] REJECTS THE PLAN
Dated: 6 -t -/ j Print or type n
B y : ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - + - = = = ~ __
Name of Claimant (if corporation):
Address: -L-lI----.L_-"
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 24 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF TIDS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $
(For purposes of this Ballot, it is not necessary and you should not adjust the p'rlI;ipal amount
for any accrued or un-matured interest):
M ACCEPTS THE PLAN
Dated: ()(;. - "7- tl
Check Only One
[ J REJECTS THE PLAN

Print or type name:
Signature: d: ....
By: __________________________ ___
Name of Claimant (if corporation):
U/i!4Mr1l Ccn&fJ.
Address: Ib4'J 4/1/#
.A!Uj 71fl!'2$
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 25 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQIDRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 1 ,339,711 .36
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
[xl ACCEPTS THE PLAN
Dated: June 12, 2013
Check Only One
] REJECTS THE PLAN
Print or type name: Fidelity Working Capital. LLC
Sigrurture: 4 ' ~ ~ t4i"
By: f (l.( t-- /.A)c4{2-lP6e I ~ ~ ~ ~ u J I ~
Name of Claimant (if corporation):
Fidelity Working Capital. LLC as assignee of Contract Operator
Production Services,
Address: 9400 Old Hammond Hwy. II C
Baton RaJ Ige, I A 70809
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 8t. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 26 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 735,297.33
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
Check Only One
[x] ACCEPTS THE PLAN ] REJECTS THE PLAN
Dated: June 12, 2013 Print or type name: Fidelity Working Capital, LLC
Signarnre: f"
By:
Name of Claimant (if corporation):
Fidelity Working Capital. LLC as assignee of Contract Operator
Address: 9400 Old Hammond Hwy Services,
Baton ROIIge I A 70809
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 27 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class !i'lJt&-b((Claim in the unpaid amount of
$ (F or purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
ACCEPTS THE PLAN
Check Only One
] REJECTS THE PLAN
Dated: (piJ 0/ /3
J I
Signature: __ ---'--='--=---=-_______ _
Title (if corporation): ____ _
v
Name of Claimant (if corporation):
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
'"BfJ b '0> b'i t1J vl/l
(Jal1.UJ (; 7!J; hi Yj.J v'}l
201 st. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
I ( a 1!)0letK
iet II 1M <.10 i} tfl.."h vtJbn C/;4-
{j;f- 4 d( :J )-'-LffO.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 28 of 40
May 16 13 09:56a Gulf Coast Heritage Realt 2288722777 p.3
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF TIDS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Chrimant, holder of a Class __ Claim in the unpaid amount of
$ (For purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
Check Only One
l ACCEPTS THE PLAN
-' Dated: L (1:1
I 1/
[
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 2013.
-S-'TD "'- "'- A ND I LI- S 6;
\(0 C', W d __ '-d
S(J1-fv0(W P.
W' J.. '- I I {lIf Co mptl-N I
0, lA II-..\-.I
.

Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 29 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class __ Claim in the unpaid amount of
$ (For purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
[jACCEPTS THE PLAN
Check Only One
] REJECTS THE PLAN
Print or type

Title (if corporation): _________ _
Name of Claimant (if corporation):
Address:
tOee'CZ.,v'
7 < ...
- 1'7..3-: CJ.:z ,;:J...,.{)-
BALLOT MUST BE MAILED OR HAND DELIVERED TO: .;?::2.?-
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place st. Charles
201 st. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013. .
ou, .


3
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Ballots Page 30 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder ofa Class 3 Claim in the unpaid amount of$
(For purposes of this Ballot, it is not necessary and you should not adjust the ount
for any accrued or un-matured interest):
[ ] ACCEPTS THE PLAN
Check Only One

Print or type name: _____ -.,.--___ _
Signature: ____________ _
By: ______________ __
Name of Claimant (if corporation): ,)
fnootJLuh o4bofA LLC
Address: ) 5a., () :ro \ 0 d,M?'\) 3i .
IV k () I LHd L Yt JOILS
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
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Ballots Page 31 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder ofa Class 3 Claim in the unpaid amount of$ Y t Jf
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
[ ] ACCEPTS THE PLAN
Dated: 2'- 2G' -CJ
Check Only One

Print or type name: _____ ---:-___ _
Signature: ____________ _
By: _______________ ___
Name of Claimant (if corporation):

Address: lSd-\,) '-;\,g J':I1,'
N D iy 6 f \ @II-j I l A 7()I 15
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 32 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ t Z t 9JD , j;
(For purposes of this Ballot, it is not necessary and you should not adjust the amount
for any accrued or un-matured interest):
[ ] ACCEPTS THE PLAN
Dated: S 2-0 . 13
Check Only One

Print or type?: 'fj:h:ir, 1l. \ 1n gfl"jL],.
Signature:
By: &0 kt lk j:J\ '1 ..
Name of Claimant (if corporation):
Address: _____________ _
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 33 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ 61 ,085.13
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
Check Only One
[ ] ACCEPTS THE PLAN [x] REJECTS THE PLAN
Dated: 06/06/13
Print or type name: TARPON
Signature: ~ :2:;
By: ERNEST P. GAUTREAUX, JR.
Name of Claimant (if corporation):
TARPON RENTAL, INC.
Address: P.O. BOX 9023
HOUMA, LA 70363_
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place st. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 34 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class __ Claim in the unpaid amount of
$ (F or purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
Check Only One
[ ] ACCEPTS THE PLAN REJECTS THE PLAN
Dated: b /3/15
( I
Print or type "'P>R.2.!Roc.I"
SIgnature: __ __ _____ _
Title (if corporation): _________ _
Name of Claimant (if corporation):
Address: I ZZ7 6c-1'C}/\.fr
7
fIXF Uf\.
W;/Jrt:-'"72 PI- 9
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 35 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class __ Claim in the unpaid amount of
$ (F or purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
[ ] ACCEPTS THE PLAN
Dated: 6ft!; /;3
7 ,/
Check Only One
REJECTS THE PLAN
Print or type name:
Signature:

Title (if corporation): _________ _
Name of Claimant (if corporation):
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place st. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12, 2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 36 of 40
UNCOUNTED BALLOTS
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 37 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF TIDS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class __ Claim in the unpaid amount of
$ (tfIJ!l)l> - cXP (For purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
Check Only One
[ ] ACCEPTS THE PLAN
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place S1. Charles
201 S1. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 38 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The undersigned Claimant, holder of a Class 3 Claim in the unpaid amount of $ ____ _
(For purposes of this Ballot, it is not necessary and you should not adjust the principal amount
for any accrued or un-matured interest):
Check Only One
[ ] ACCEPTS THE PLAN ] REJECTS THE PLAN

--
By: ____________________________ ___
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
Ballots Page 39 of 40
ACCEPTANCE OR REJECTION OF THE PLAN
PLEASE INSERT THE AMOUNT OF CLAIM BEING VOTED, THE DATE OF
EXECUTION OF THIS BALLOT, THE VOTE ITSELF, AND FINALLY, PLEASE FILL
IN THE SIGNATORY INFORMATION REQUIRED BELOW.
The Claimant, holder of a Class S Claim in the unpaid amount of
$ (For purposes of this Ballot, it is not necessary and you should not
adjust the principal amount for any accrued or un-matured interest):
[ ] ACCEPTS THE PLAN
Dated: 5/ZZ/13
Check Only One
] REJECTS THE PLAN
Title (if corporation):
Name of Claimant (if corporation):
!lir@,[/fflE:t,-10f...OtS}rf.5, (A.,c
6 Vf.lPOGtiNfi 1}J;etJwJl/
BALLOT MUST BE MAILED OR HAND DELIVERED TO:
GORDON, ARATA, MCCOLLAM,
DUPLANTIS & EAGAN, LLC
Attention: Virgin Offshore Claims Balloting
Place St. Charles
201 St. Charles Avenue, Suite 4000
New Orleans, LA 70170-4000
SO THAT IT IS RECEIVED NO LATER THAN: June 12,2013.
3
Case 11-13028 Doc 435-1 Filed 06/14/13 Entered 06/14/13 15:25:46 Original
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