Granite State Gas Transmission, Inc.

Third Revised Volume No. 1

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

Original Sheet No. 503 Original Sheet No. 503 : Effective

FORM FOR REQUEST FOR TRANSPORTATION SERVICE

(continued)

(h) The maximum daily quantity to be transported is ____________

Dth with an estimated total quantity of gas to be transported

during the requested term of service of ____________ Dth.

(i) Term

(1) Date service is proposed to commence ______________.

(2) Term of Service _______ months, _______ years.

(3) Date of termination ____________________ .

(4) Evergreen? yes ________ no ________.

(j) Name and detailed description of Receipt Point(s) into

Transporter's system and the maximum daily quantities of gas

to be delivered by Shipper for each point:

Receipt Upstream

Point MDRO Term Transp. Supplier

________ ________ ________ ________ ________

________ ________ ________ ________ ________

Name and detailed description of Delivery Point(s) where

Transporter will redeliver the gas and the maximum daily

quantities of gas to be redelivered by Transporter for each

point:

Name of End Use

Delivery Party Location

Point MDRO Term Recv Gas (State)

________ ________ ________ ________ ________

________ ________ ________ ________ ________

(k) Type of service requested:

________ Firm - FT-1

________ Firm - FT-NN

________ Interruptible -IT-1