American Midstream (Midla), LLC

Sixth Revised Volume No. 1

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Effective Date: 05/01/2010, Docket: RP10-483-000, Status: Effective

Original Sheet No. 366 Original Sheet No. 366


6. If the service requested is ?on behalf? of a 311 entity, please complete the

following as it pertains to the 311 Party:











311 Party Status: _____ Hinshaw _____ LDC _____ Interstate


Location (by State) of 311 Party's Facilities:_________________________


(Pipeline reserves the right to require proof that Customer's request meets the

requirements of the applicable Commission Regulations)


7. If Customer is not a local distribution company and is requesting service be

performed by Pipeline for Customer acting as agent for another entity, please specify the

full legal name of such entity.




8. Date service is proposed to



9. Maximum Daily Transportation Quantity (MMBtu/Day):_____________________


10. Term of service: years months


11. Transportation Rate Requested:


Demand $ _____________

Commodity $ _____________


12. Identity of Upstream and Downstream Pipelines involved in the transaction:

Upstream: __________________________________________________

Downstream: __________________________________________________


13. Midla Receipt Point(s): ______________________________________


14. Midla Delivery Point(s):______________________________________

(if request is for firm transportation service, the sum of these maximum quantities must

equal the maximum transportation quantity in #9 above.)


15. If additional or new facilities are required to receive or deliver gas for the

transportation service requested herein, please provide description of facilities required,

location, and requested in-service date.