Granite State Gas Transmission, Inc.

Third Revised Volume No. 1

 Contents / Previous / Next / Main Tariff Index

Effective Date: 12/13/1993, Docket: RS93- 1-001, Status: Effective

Original Sheet No. 502 Original Sheet No. 502 : Effective

FORM FOR REQUEST FOR TRANSPORTATION SERVICE

(continued)

(d) The specific affiliation of the requester with Transporter, if

any: ______________________________________.

(e) Name of Shipper's contact, address and telephone number

through which correspondence for the following should be

directed:

Contact for Request: ____________________________________

____________________________________

____________________________________

____________________________________

Contact for Notices: ____________________________________

____________________________________

____________________________________

____________________________________

Contact for Invoices: ____________________________________

____________________________________

____________________________________

____________________________________

(f) Are additional or new facilities required to receive or deliv-

er gas for the transportation service requested herein?

_______ Yes _______ No.

(g) Name and full title of Officer (or General Partner) of Shipper

who will execute written transportation agreement with Trans-

porter.

____________________________ ____________________________

Name Title