American Midstream (AlaTenn), LLC

Fifth Revised Volume No. 1

 Contents / Previous / Next / Main Tariff Index

 

 

Effective Date: 05/01/2010, Docket: RP10-493-000, Status: Effective

Original Sheet No. 338 Original Sheet No. 338

 

TRANSPORTATION SERVICE REQUEST FORM

 

 

American Midstream (AlaTenn), LLC

1614 15th Street, Suite 300

Denver, CO 80202

 

 

Attention: Gas Transportation Service

 

 

Re: New Service Interruptible Service

or or

Modification Firm Service

of Existing Service

 

(Description of existing service to be modified:

 

 

 

 

Gentlemen:

 

(Shipper) hereby requests Transportation Service from American Midstream

(AlaTenn), LLC

(AlaTenn)

and concurrently provides the following information in connection with this

request:

 

1. Complete legal name of Shipper:

 

 

 

2. Type of legal entity and state of incorporation:

 

 

 

3. Type of Company:

Local Distribution Company

Intrastate Pipeline

Interstate Pipeline

Producer

End-User

Marketer

Broker

Other (fill in)