Granite State Gas Transmission, Inc.

Fourth Revised Volume No. 1

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Effective Date: 03/01/2010, Docket: RP10-322-000, Status: Effective

Original Sheet No. 189 Original Sheet No. 189

FORM FOR REQUEST FOR TRANSPORTATION SERVICE

(Continued)

that the information set forth in this transportation request is

correct and accurate and that all necessary transportation

arrangements with the upstream and downstream transporters, as

stated herein, have been or will be secured prior to the

commencement of the requested transportation services.

If requesting firm service, Shipper has enclosed a check in the

amount of the necessary pre-payment charge for firm service under

Rate Schedule FT-1.

Very truly yours,

Signature: _________________

Name: _________________

Title: _________________