Garden Banks Gas Pipeline, LLC

Original Volume No. 1

Effective Date: 12/01/2004, Docket: RP05- 56-000, Status: Effective

First Revised Sheet No. 300 First Revised Sheet No. 300 : Effective

Superseding: Original Sheet No.300

FORM OF SERVICE REQUEST FORM

11. Name and description of Delivery Point(s) where Transporter

will redeliver the gas and the maximum daily quantities

expressed in Mcf of gas to be redelivered by Transporter at

each point. (If the request is for service under Rate

Schedules FT-1 or FT-2 then the sum of the maximum daily

quantities above must equal the maximum daily quantity in 9

above.)

_____________________________________________

12. Credit Evaluation - Unless previously provided to

Transporter in the prior three months, a Shipper seeking

service from Transporter under Rate Schedules FT-1, FT-2 or

IT-1 must provide:

(a) a copy of Shipper's most recent twelve months audited

financial statements or Annual Report and, if applicable, form 10-

K; or

if not available

(b) a copy of Shipper's most recent audited financial

statement certified by the Chief Financial Officer or

Chief Accounting Officer of the Shipper (which

certificate shall state that such financial statements

fairly present the financial condition and results of

operation of the Shipper for the period indicated

therein) prepared in accordance with generally accepted

accounting principles; and in all cases

subsidiaries, if applicable.

13. Is Shipper affiliated with Garden Banks Gas Pipeline, LLC?

______ Yes ______ No

If yes, what is the percentage of affiliation? ______ %

14. Is your supplier affiliated with Garden Banks Gas Pipeline,

LLC?

______ Yes ______ No

If yes, what is the percentage of affiliation? ______ %