Southern Star Central Gas Pipeline, Inc.

Original Volume No. 1

 Contents / Previous / Next / Main Tariff Index

Effective Date: 05/01/2003, Docket: RP03-352-000, Status: Effective

Original Sheet No. 481 Original Sheet No. 481 : Superseded

SERVICE REQUEST FORM

8. Requested Term of Service:

Initial Delivery Date__________________

Termination Date __________________

9. Address for Billing: Address For Notices:*

_______________________________ ________________________________

_______________________________ ________________________________

_______________________________ ________________________________

Attn: (Prefer Title)__________ Attn: (Prefer Title)___________

Telephone No.__________________ (*Please include a street

address

Fax No.________________________ for Federal Express

correspondence.)

Telephone No.___________________

Fax No._________________________