Portland Natural Gas Transmission System

Second Revised Volume No. 1

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Effective Date: 09/01/2006, Docket: RP06-449-000, Status: Effective

Original Sheet No. 552 Original Sheet No. 552 : Effective

REQUEST FOR SERVICE

(1) Type of Service.

(Name) (hereafter "Requester") herein requests service from

Portland Natural Gas Transmission System (hereafter "PNGTS")

under Rate Schedule (specify)

(2) Complete Legal Name of Service Applicant:

_____________________________________________________________________

(a) Type of Legal Entity:

(b) State of Incorporation:

(c) Shipper is (Check one):

Interstate Pipeline Intrastate Pipeline

End-User Local Distribution Company

Broker Producer

Marketer Other

(3) Gas Quantities

Receipt Points Maximum Daily Quantity

(List) (Amount)

(Total)

Delivery Points Maximum Daily Quantity

(List) (Amount)

(Total)