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
______________________________________
______________________________________
______________________________________
______________________________________