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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> -• j-it ma ,an return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. <br /> 1, Artici- D. Is delivery address different from item 11 ❑Yes <br /> If YES,aster delivery address below: ❑ No <br /> Jean De Ridder <br /> Total E&P USA Oil Shale, LLC <br /> 705 Forest Ave <br /> Palo Alto,CA 94301 3. Service Type ❑Priority Mad Express® <br /> II I'II I I'I ICI I II I IIIII I II III II I I I(I'I I�)I i ❑Adult Signature ❑Registered Mairrl <br /> ❑Adult Signature Restricted Delivery ❑ istered Mail Restricted <br /> 9590 9402 2053 6132 7804 32 ❑❑C Cemfied Mail® ❑D fe" <br /> ertified Mail Restricted Delivery Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service/alien ❑Collect on Delivery Restricted Delivery ❑Signature Confirmationn" <br /> I Insured Mail ❑Signature Confirmation <br /> 7 016 2140 0000 2346 0639 Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> CERTIFIED MAIL' <br /> COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman Street,Room 215 7016 2140 0000 2346 0639 <br /> Denver,CO 80203-2243 <br /> 7016 2140 0000 2346 0639 <br /> 341300000 <br /> iw 9 m <br /> .- ' • <br /> 'q! [fill! <br /> • . <br /> Jean De Rid <br /> z <br /> Total E&PU o NNNN» <br /> 705 Forest A i;� , <br /> Palo Alto, CA - - <br /> 1 <br />