Mogas Pipeline LLC (Fomerly Missouri Interstate Gas)

First Revised Volume No. 1

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Effective Date: 06/01/2008, Docket: CP06-407-002, Status: Effective

Original Sheet No. 103 Original Sheet No. 103 : Pending

 

 

MoGas Pipeline LLC

FORM OF TRANSPORTATION SERVICE CREDIT AGREEMENT

 

 

 

Shipper Name and Address

 

___________________________________

___________________________________

___________________________________

___________________________________

 

Type of business __ Corporation __ Partnership __ Individual

__ Other (specify)_______________________________

 

State in which Shipper is incorporated

_________________________________

 

Tax ID Number _________________________________

 

Number of years in business under current name _________

 

Has the Shipper changed its name in the last 5 years Yes No

 

If yes, furnish prior name and address:

____________________________________

____________________________________

____________________________________

____________________________________

 

List the three principal owners, stockholders, partners, or officers of the

Shipper

 

Name_____________________Name ___________________

Name______________________

Title ___________________Title ___________________Title ____________________

Address__________________Address__________________Address___________________

_________________________ ________________________ ________________________

_________________________ ________________________ _______________________

Phone___________________ Phone____________________ Phone____________________

Email___________________ Email_____________________Email____________________

 

If a wholly owned subsidiary, name and address of parent

______________________________________

______________________________________

______________________________________

______________________________________