Garden Banks Gas Pipeline, LLC

Original Volume No. 1

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Effective Date: 05/10/2010, Docket: RP10-594-000, Status: Effective

First Revised Sheet No. 303 First Revised Sheet No. 303

Superseding: Original Sheet No. 303

CUSTOMER NOMINATION FORM

ALL INFORMATION MUST BE FURNISHED TO GARDEN BANKS GAS PIPELINE, LLC

PURSUANT TO SECTION 11 OF THE GENERAL TERMS AND CONDITIONS OF GARDEN BANKS GAS

PIPELINE, LLC'S FERC GAS TARIFF.

Shipper:

Contact:____________________

Title:_______________________

____________________________ Date:

Number:_____________________ Facsimile: